Provider Demographics
NPI:1528117744
Name:CATHOLIC CHARITIES OF MICHIGAN INCORPORATED
Entity type:Organization
Organization Name:CATHOLIC CHARITIES OF MICHIGAN INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:734-223-1844
Mailing Address - Street 1:199 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2762
Mailing Address - Country:US
Mailing Address - Phone:517-263-2191
Mailing Address - Fax:517-264-6080
Practice Address - Street 1:199 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2762
Practice Address - Country:US
Practice Address - Phone:517-263-2191
Practice Address - Fax:517-264-6080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health