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General NPI Number Information
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NPI Number | 1881862662
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Entity Type | Organization
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Legal Business Name | CATHOLIC SOCIAL SERVICES OF THE UPPER PENINSULA
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 616 SHELDEN AVE STE 211
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City | HOUGHTON
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State | MI
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Zip | 49931-1841
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Country | US
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Telephone | 906-482-1624
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Fax | 906-482-8301
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Provider Business Mailing Address
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Address Line | 616 SHELDEN AVE STE 211
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City | HOUGHTON
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State | MI
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Zip | 49931-1841
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Country | US
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Telephone | 906-482-1624
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Fax | 906-482-8301
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LAURENCE ZIOMKOWSKI
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Credential |
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Telephone | 906-227-9116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 310040
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License Number State | MI
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