Organization
COPPER COUNTRY COMMUNITY MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE J. POLLACK PHD. (EXECUTIVE DIRECTOR)
(906) 482-9400
Entity
Organization
Contact information
Practice address
15644 SKANEE RD, LANSE, MI 49946-9003
(906) 524-5885
(906) 483-0269
Mailing address
901 W. MEMORIAL DR., HOUGHTON, MI 49931
(906) 482-9400
(906) 483-0269
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10603
BLUE CROSS BLUE SHIELD MI
—
05
—
1707962
—
MI
Enumeration date
10/01/2007
Last updated
10/01/2007
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