# MACOMB CHILDREN'S HEALTHCARE ACCESS PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073976239
- **Authorized official:** MS. MONICA WOODSON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (586) 459-5108

## Contact information

- **Practice address:** 11370 HUPP AVE, WARREN, MI 48089-2505
- **Practice address phone:** (586) 459-5108
- **Practice address fax:** (586) 459-5186
- **Mailing address:** 11370 HUPP AVE, WARREN, MI 48089-2505
- **Mailing address phone:** (586) 459-5108
- **Mailing address fax:** (586) 459-5186

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |

## Other

- **Enumeration date:** 04/04/2016
- **Last updated:** 04/04/2016