Provider Demographics
NPI:1689046856
Name:COMMUNITY SPIRIT HOMES INCORPORATED
Entity Type:Organization
Organization Name:COMMUNITY SPIRIT HOMES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTORQ
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-254-9090
Mailing Address - Street 1:5860 N CANTON CENTER RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2687
Mailing Address - Country:US
Mailing Address - Phone:734-254-9090
Mailing Address - Fax:734-254-9099
Practice Address - Street 1:5860 N CANTON CENTER RD STE 320
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2687
Practice Address - Country:US
Practice Address - Phone:734-254-9090
Practice Address - Fax:734-254-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities