Organization
COMMUNITY COUNSELING AND MENTORING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN ANN GAVIN BA (OFFICE MANAGER)
(810) 987-2681
Entity
Organization
Contact information
Practice address
312 SUPERIOR MALL, PORT HURON, MI 48060-3833
(810) 987-2681
(810) 987-2784
Mailing address
312 SUPERIOR MALL, PORT HURON, MI 48060-3833
(810) 987-2681
(810) 987-2784
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6401005551
MI
Other
Enumeration date
07/03/2007
Last updated
12/05/2008
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