Provider Demographics
NPI:1134846892
Name:E-COMMUNITY OUTREACH SERVICES
Entity type:Organization
Organization Name:E-COMMUNITY OUTREACH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:248-622-4334
Mailing Address - Street 1:953 W HURON ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-3727
Mailing Address - Country:US
Mailing Address - Phone:248-622-4334
Mailing Address - Fax:
Practice Address - Street 1:953 W HURON ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3727
Practice Address - Country:US
Practice Address - Phone:248-622-4334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management