Provider Demographics
NPI:1356495295
Name:ARAB COMMUNITY CENTER FOR ECONOMIC AND SOCIAL SERVICES
Entity type:Organization
Organization Name:ARAB COMMUNITY CENTER FOR ECONOMIC AND SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1313-842-7010
Mailing Address - Street 1:1247 MANORWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1529
Mailing Address - Country:US
Mailing Address - Phone:248-299-8029
Mailing Address - Fax:
Practice Address - Street 1:6450 MAPLE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2259
Practice Address - Country:US
Practice Address - Phone:313-216-2200
Practice Address - Fax:313-584-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068995251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4276661Medicaid
MI4276661Medicaid
MI4276661Medicare ID - Type Unspecified