Provider Demographics
NPI:1285627513
Name:CARE OF SOUTHEASTERN MICHIGAN
Entity Type:Organization
Organization Name:CARE OF SOUTHEASTERN MICHIGAN
Other - Org Name:COMMUNITY ASSESSMENT REFERRAL & EDUCATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STYF
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:586-541-2273
Mailing Address - Street 1:31900 UTICA RD.
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026
Mailing Address - Country:US
Mailing Address - Phone:586-541-0033
Mailing Address - Fax:586-541-0034
Practice Address - Street 1:31900 UTICA RD.
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026
Practice Address - Country:US
Practice Address - Phone:586-541-0033
Practice Address - Fax:586-541-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 261Q00000X
MISA0500016251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center