Provider Demographics
NPI:1598049934
Name:COMMUNITY ENTERPRISES OF ST. CLAIR COUNTY
Entity Type:Organization
Organization Name:COMMUNITY ENTERPRISES OF ST. CLAIR COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYCHAL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FEARNCOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-982-3261
Mailing Address - Street 1:1033 26TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-4853
Mailing Address - Country:US
Mailing Address - Phone:810-982-3261
Mailing Address - Fax:810-982-2225
Practice Address - Street 1:1033 26TH ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-4853
Practice Address - Country:US
Practice Address - Phone:810-982-3261
Practice Address - Fax:810-982-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services