Organization
COORDINATED COMMUNITY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA ABBATE-MARZOLF (CEO)
(248) 262-9200
Entity
Organization
Contact information
Practice address
29100 NORTHWESTERN HWY STE 400, SOUTHFIELD, MI 48034-1091
(248) 357-2255
(248) 948-9691
Mailing address
29100 NORTHWESTERN HWY STE 400, SOUTHFIELD, MI 48034-1091
(248) 357-2255
(248) 948-9691
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4508980
—
MI
Enumeration date
09/26/2006
Last updated
01/14/2014
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