Provider Demographics
NPI:1467896050
Name:COMMUNITY NETWORK SERVICES
Entity Type:Organization
Organization Name:COMMUNITY NETWORK SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KEON
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-335-8710
Mailing Address - Street 1:30 E MONTCALM ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-1348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 E MONTCALM ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-1348
Practice Address - Country:US
Practice Address - Phone:248-335-8710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health