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General NPI Number Information
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NPI Number | 1629109350
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Entity Type | Organization
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Legal Business Name | PEOPLE'S COMMUNITY SERVICES OF METROPOLITANDETROIT
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 570 CLINTON ST
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City | DETROIT
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State | MI
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Zip | 48226-2334
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Country | US
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Telephone | 313-224-8194
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Fax |
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Provider Business Mailing Address
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Address Line | 412 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48216-1412
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Country | US
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Telephone | 313-554-3113
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. THOMAS CERVENAK
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Credential | M.A.
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Telephone | 313-554-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | MI
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