Healthcare Provider Details

I. General information

NPI: 1578014940
Provider Name (Legal Business Name): COMMUNITY PROGRAMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 SUMMIT DR
WATERFORD MI
48328-3364
US

IV. Provider business mailing address

1255 N OAKLAND BLVD
WATERFORD MI
48327-1545
US

V. Phone/Fax

Practice location:
  • Phone: 248-599-8999
  • Fax:
Mailing address:
  • Phone: 248-599-8999
  • Fax: 248-406-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateMI

VIII. Authorized Official

Name: NICOLE POWELL
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 947-957-6247