Provider Demographics
NPI:1801904594
Name:LIVINGSTON COUNTY CATHOLIC CHARITIES
Entity type:Organization
Organization Name:LIVINGSTON COUNTY CATHOLIC CHARITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:TABOR
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-545-5944
Mailing Address - Street 1:2020 E GRAND RIVER
Mailing Address - Street 2:STE 104
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843
Mailing Address - Country:US
Mailing Address - Phone:517-545-5944
Mailing Address - Fax:517-545-7390
Practice Address - Street 1:2020 E GRAND RIVER
Practice Address - Street 2:STE 104
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843
Practice Address - Country:US
Practice Address - Phone:517-545-5944
Practice Address - Fax:517-545-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty