CHASS MACK – NPI #1013617364
Clinic/Center

CHASS MACK is an AHC clinic located in DETROIT, MI. NPPES has assigned the NPI number 1013617364 to CHASS MACK on March 06, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CHASS MACK” is a dba name, the actual legal business name for this organization is COMMUNITY HEALTH AND SOCIAL SERVICES CENTER, INC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was last updated on Aug 08, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHASS MACK below.

NPI Profile for
COMMUNITY HEALTH AND SOCIAL SERVICES CENTER, INC

NPI Number
1013617364
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COMMUNITY HEALTH AND SOCIAL SERVICES CENTER, INC
Doing Business As (dba): CHASS MACK
Primary location
3426 MACK AVENUE
DETROIT, MI 48207
Phone: (313) 849-3920 Fax:
Mailing address
5635 W FORT ST
DETROIT, MI 48209-3154
Phone: (313) 849-3920 Fax: (313) 849-0824
Organization Subpart
No
Authorized Official
FELIX VALBUENA
CEO
Phone: (313) 849-3920
Updated
Certification Date
Aug 08, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.