Healthcare Provider Details

I. General information

NPI: 1902778236
Provider Name (Legal Business Name): CARE CONNECT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3189 POPLAR AVE STE 140
WARREN MI
48091-2343
US

IV. Provider business mailing address

24225 W 9 MILE RD STE 140
SOUTHFIELD MI
48033-3979
US

V. Phone/Fax

Practice location:
  • Phone: 313-924-3906
  • Fax: 313-908-5066
Mailing address:
  • Phone: 313-924-3906
  • Fax: 313-908-5066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TINA ROBINSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LPN
Phone: 313-924-3906