Provider Demographics
NPI:1043368558
Name:COMMUNITY LIVING SERVICES OF OAKLAND COUNTY
Entity Type:Organization
Organization Name:COMMUNITY LIVING SERVICES OF OAKLAND COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW, QIDP
Authorized Official - Phone:248-547-2668
Mailing Address - Street 1:3270 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1161
Mailing Address - Country:US
Mailing Address - Phone:248-547-2668
Mailing Address - Fax:
Practice Address - Street 1:642 E. NINE MILE RD.
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220
Practice Address - Country:US
Practice Address - Phone:248-547-2668
Practice Address - Fax:248-547-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization