Healthcare Provider Details
I. General information
NPI: 1306981675
Provider Name (Legal Business Name): ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2007
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14675 DOWNEY RD
CAPAC MI
48014-3016
US
IV. Provider business mailing address
3111 ELECTRIC AVE
PORT HURON MI
48060-8127
US
V. Phone/Fax
- Phone: 810-395-4343
- Fax:
- Phone: 810-985-8900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEBRA
B
JOHNSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 810-985-8900