Provider Demographics
NPI:1083055156
Name:COMMUNITY NETWORK SERVICES FARMINGTON HILLS
Entity Type:Organization
Organization Name:COMMUNITY NETWORK SERVICES FARMINGTON HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASEMANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARYA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:COTTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:248-871-1467
Mailing Address - Street 1:38855 HILLS TECH DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3421
Mailing Address - Country:US
Mailing Address - Phone:248-994-8001
Mailing Address - Fax:
Practice Address - Street 1:38855 HILLS TECH DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3421
Practice Address - Country:US
Practice Address - Phone:248-994-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802076608251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health