Organization
COMMUNITY HEALTH AND SOCIAL SERVICES CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX MARIO VALBUENA JR. MD (CEO)
(313) 849-3920
Entity
Organization
Contact information
Practice address
5635 W FORT ST, DETROIT, MI 48209-3154
(313) 849-3920
(313) 849-0824
Mailing address
5635 W FORT ST, DETROIT, MI 48209-3154
(313) 849-3920
(313) 849-0824
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080Q246390
BC/BS OF MICHIGAN
MI
Enumeration date
10/27/2005
Last updated
11/15/2022
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