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Organization

COMMUNITY CARE SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAYMOND KYLE BAYNE III MED. (MENTAL HEALTH THERAPIST III)
(313) 382-7861
Entity
Organization

Contact information

Practice address
1736 FORT ST, LINCOLN PARK, MI 48146-1904
(313) 382-7861
Mailing address
28541 SPRUCE DR, FLAT ROCK, MI 48134-9772
(734) 782-4453

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary

Other

Enumeration date
03/02/2007
Last updated
08/30/2011
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