Provider Demographics
NPI:1720422157
Name:COMMUNITY NETWORK SERVICES
Entity Type:Organization
Organization Name:COMMUNITY NETWORK SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LLBSW
Authorized Official - Phone:248-409-4213
Mailing Address - Street 1:451 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-1962
Mailing Address - Country:US
Mailing Address - Phone:248-340-0281
Mailing Address - Fax:
Practice Address - Street 1:451 MOORE ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-1962
Practice Address - Country:US
Practice Address - Phone:248-340-0281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802087448251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management