MEDICARE: CATHOLIC SOCIAL SERVICES OF OAKLAND COUNTY

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	251S00000X	Community/Behavioral Health Agency	631287	MI

General Provider Information

NPI Number	:	1770744039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC SOCIAL SERVICES OF OAKLAND COUNTY

Provider Business Mailing Address
First Line	:	715 N LAPEER RD
Second Line	:
City	:	LAKE ORION
State	:	MI
Zip	:	48362-1530
Country	:	US
Telephone Number	:	248-537-3300
Fax Number	:	248-537-3306

Provider Business Practice Location Address
First Line	:	715 N LAPEER RD
Second Line	:
City	:	LAKE ORION
State	:	MI
Zip	:	48362-1530
Country	:	US
Telephone Number	:	248-537-3300
Fax Number	:	248-537-3306

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. STACI L ALLMAND
Credential	:	LMSW
Telephone Number	:	248-666-8870

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	06/19/2008

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