Provider Demographics
NPI:1013208982
Name:METRO COMMUNITY SERVICES
Entity Type:Organization
Organization Name:METRO COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:MIKULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:313-770-3028
Mailing Address - Street 1:48792 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-8308
Mailing Address - Country:US
Mailing Address - Phone:313-770-3028
Mailing Address - Fax:
Practice Address - Street 1:48792 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-8308
Practice Address - Country:US
Practice Address - Phone:313-770-3028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health