Healthcare Provider Details

I. General information

NPI: 1679687339
Provider Name (Legal Business Name): CATHOLIC SOCIAL SERVICES OF WASHTENAW COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 PACKARD ST
ANN ARBOR MI
48108-1521
US

IV. Provider business mailing address

4925 PACKARD ST
ANN ARBOR MI
48108-1521
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-9781
  • Fax: 734-971-2730
Mailing address:
  • Phone: 734-971-9781
  • Fax: 734-971-2730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PEGGY MCDONAGH BRAVO
Title or Position: PRESIDENT AND CEO
Credential: RN, BSN, MA
Phone: 734-926-0154