Provider Demographics
NPI:1043605876
Name:MICHIGAN COMMUNITY SERVICES INC
Entity Type:Organization
Organization Name:MICHIGAN COMMUNITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-635-4407
Mailing Address - Street 1:PO BOX 317
Mailing Address - Street 2:
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-0317
Mailing Address - Country:US
Mailing Address - Phone:810-635-4407
Mailing Address - Fax:810-635-4086
Practice Address - Street 1:11411 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-2703
Practice Address - Country:US
Practice Address - Phone:810-635-4407
Practice Address - Fax:810-635-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services