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General NPI Number Information
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NPI Number | 1609844976
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE SERVICES
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 26184 W OUTER DRIVE
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City | LINCOLN PARK
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State | MI
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Zip | 48146
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Country | US
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Telephone | 313-389-7525
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Fax | 313-389-7515
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Provider Business Mailing Address
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Address Line | 26184 W OUTER DRIVE
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City | LINCOLN PARK
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State | MI
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Zip | 48146
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Country | US
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Telephone | 313-389-7525
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Fax | 313-389-7515
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. WILLIAM P WALSH
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Credential | LMSW
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Telephone | 313-389-7525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 820588
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 820521
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 820428
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License Number State | MI
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