Healthcare Provider Details

I. General information

NPI: 1497613640
Provider Name (Legal Business Name): DOWNRIVER COMMUNITY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 TAFT RD
CLAY MI
48001-4701
US

IV. Provider business mailing address

555 SAINT CLAIR RIVER DR
ALGONAC MI
48001-1802
US

V. Phone/Fax

Practice location:
  • Phone: 810-794-4911
  • Fax: 810-794-4407
Mailing address:
  • Phone: 810-794-4917
  • Fax: 810-794-4407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MIKE BARANOWSKI
Title or Position: CEO
Credential: CEO
Phone: 586-270-8055