Provider Demographics
NPI:1295336394
Name:KCS COMMUNITY SERVICES INC
Entity type:Organization
Organization Name:KCS COMMUNITY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEENAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:313-829-7241
Mailing Address - Street 1:23800 W 10 MILE RD STE 236
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3199
Mailing Address - Country:US
Mailing Address - Phone:586-504-0854
Mailing Address - Fax:
Practice Address - Street 1:16577 MUIRLAND ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-3012
Practice Address - Country:US
Practice Address - Phone:313-829-7241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health