Provider Demographics
NPI:1609170505
Name:COMMUNICARE MICHIGAN, LLC.
Entity Type:Organization
Organization Name:COMMUNICARE MICHIGAN, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSTED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-212-8891
Mailing Address - Street 1:PO BOX 2712
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-2712
Mailing Address - Country:US
Mailing Address - Phone:248-212-8891
Mailing Address - Fax:
Practice Address - Street 1:2501 ROCHESTER CT
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1875
Practice Address - Country:US
Practice Address - Phone:248-212-8891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities