Organization
COMMUNITY CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN FENWICK (DIRECTOR)
(313) 389-7548
Entity
Organization
Contact information
Practice address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7500
Mailing address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7500
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
6401005512
MI
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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