Provider Demographics
NPI: | 1851868582 |
---|---|
Name: | COMMUNITY VETERANS SERVICES INC |
Entity Type: | Organization |
Organization Name: | COMMUNITY VETERANS SERVICES INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KAREN |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | TURNER-WOMACK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 248-991-5931 |
Mailing Address - Street 1: | 163 TENNYSON |
Mailing Address - Street 2: | |
Mailing Address - City: | HIGHLAND PARK |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48203 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 248-991-5931 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 163 TENNYSON |
Practice Address - Street 2: | |
Practice Address - City: | HIGHLAND PARK |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48203 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-991-5931 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-10-31 |
Last Update Date: | 2018-10-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 385H00000X | Respite Care Facility | Respite Care | ||
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YP1600X | Behavioral Health & Social Service Providers | Counselor | Pastoral | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 171W00000X | Other Service Providers | Contractor | Group - Multi-Specialty | |
No | 171WH0202X | Other Service Providers | Contractor | Home Modifications | Group - Multi-Specialty |
No | 2471Q0001X | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Quality Management | Group - Multi-Specialty |
No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care | |
No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 364SH1100X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Holistic | Group - Multi-Specialty |