Healthcare Provider Details

I. General information

NPI: 1750585493
Provider Name (Legal Business Name): CATHOLIC HUMAN SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 S RIPLEY BLVD
ALPENA MI
49707-3406
US

IV. Provider business mailing address

154 S RIPLEY BLVD
ALPENA MI
49707-3406
US

V. Phone/Fax

Practice location:
  • Phone: 989-356-6385
  • Fax: 989-356-4909
Mailing address:
  • Phone: 989-356-6385
  • Fax: 989-356-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number040002
License Number StateMI

VIII. Authorized Official

Name: DAVID R MARTIN
Title or Position: CEO
Credential:
Phone: 231-947-8110