Provider Demographics
NPI:1245434315
Name:CATHOLIC HUMAN SERVICES INC
Entity type:Organization
Organization Name:CATHOLIC HUMAN SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-947-8110
Mailing Address - Street 1:421 S MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2571
Mailing Address - Country:US
Mailing Address - Phone:231-775-6581
Mailing Address - Fax:231-775-5421
Practice Address - Street 1:421 S MITCHELL ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2571
Practice Address - Country:US
Practice Address - Phone:231-775-6581
Practice Address - Fax:231-775-5421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI830004251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20437OtherBCBS
MI0Z46022Medicare ID - Type Unspecified