MEDICARE: DEAF COMMUNITY ADVOCACY NETWORK, INC.

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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1710371166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEAF COMMUNITY ADVOCACY NETWORK, INC.

Provider Business Mailing Address
First Line	:	2111 ORCHARD LAKE RD
Second Line	:	SUITE 101
City	:	SYLVAN LAKE
State	:	MI
Zip	:	48320-1785
Country	:	US
Telephone Number	:	248-332-3331
Fax Number	:	248-332-7334

Provider Business Practice Location Address
First Line	:	2111 ORCHARD LAKE RD
Second Line	:	SUITE 101
City	:	SYLVAN LAKE
State	:	MI
Zip	:	48320-1785
Country	:	US
Telephone Number	:	248-332-3331
Fax Number	:	248-332-7334

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. MARCY WARHEIT COLTON
Credential	:	LPC
Telephone Number	:	248-332-3331

Provider Enumeration Date	:	03/24/2015
Last Update Date	:	03/24/2015

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