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NPI Code Detail

MEDICARE: COMMUNICARE MICHIGAN, LLC.

MEDICARE: COMMUNICARE MICHIGAN, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1609170505
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNICARE MICHIGAN, LLC.
Provider Business Mailing Address
First Line : PO BOX 2712
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48012-2712
Country : US
Telephone Number : 248-212-8891
Fax Number :
Provider Business Practice Location Address
First Line : 2501 ROCHESTER CT
Second Line :
City : TROY
State : MI
Zip : 48083-1875
Country : US
Telephone Number : 248-212-8891
Fax Number :
Authorized Official
Title or Position : COO
Name : DR. KRISTEN HUSTED
Credential :
Telephone Number : 248-212-8891
Provider Enumeration Date : 01/06/2011
Last Update Date : 07/14/2021

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Directions to “COMMUNICARE MICHIGAN, LLC. ” Practice Location

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