Provider Demographics
NPI:1033349352
Name:CATHOLIC SERVICES OF MACOMB
Entity Type:Organization
Organization Name:CATHOLIC SERVICES OF MACOMB
Other - Org Name:CATHOLIC SERVICES OF LAPEER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-416-2300
Mailing Address - Street 1:15945 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1610
Mailing Address - Country:US
Mailing Address - Phone:810-664-4557
Mailing Address - Fax:810-664-5181
Practice Address - Street 1:700 S MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3077
Practice Address - Country:US
Practice Address - Phone:810-664-4557
Practice Address - Fax:810-664-5181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty