Provider Demographics
NPI:1760827455
Name:COMMUNITYNETWORKSERVICES
Entity Type:Organization
Organization Name:COMMUNITYNETWORKSERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER TECH
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARLOTTA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-335-8710
Mailing Address - Street 1:3118 BROOKSHEAR CIR
Mailing Address - Street 2:
Mailing Address - City:AUBURNHILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326
Mailing Address - Country:US
Mailing Address - Phone:248-335-8710
Mailing Address - Fax:
Practice Address - Street 1:30 EAST MONTCALM ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48321
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:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management