Provider Demographics
NPI:1689085268
Name:DOWNRIVER COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:DOWNRIVER COMMUNITY SERVICES, INC.
Other - Org Name:COMMUNITY FIRST HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-749-5197
Mailing Address - Street 1:PO BOX 480430
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48048
Mailing Address - Country:US
Mailing Address - Phone:586-749-5197
Mailing Address - Fax:
Practice Address - Street 1:58144 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:MI
Practice Address - Zip Code:48048
Practice Address - Country:US
Practice Address - Phone:586-749-5197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty