Provider Demographics
NPI:1922181312
Name:COMMUNITY OPPORTUNITY CENTER
Entity Type:Organization
Organization Name:COMMUNITY OPPORTUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-422-1020
Mailing Address - Street 1:33014 5 MILE RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3075
Mailing Address - Country:US
Mailing Address - Phone:734-422-1020
Mailing Address - Fax:734-422-7401
Practice Address - Street 1:33014 5 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3075
Practice Address - Country:US
Practice Address - Phone:734-422-1020
Practice Address - Fax:734-422-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty