NPIMap

Organization Active NPI

Community Mental Health Services of St Joseph County

Doing business as Pivotal

  • Community/Behavioral Health Agency
  • Centreville, MI
National Provider Identifier
1104715036
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY MENTAL HEALTH SERVICES OF ST JOSEPH COUNTY
Doing business as
Pivotal
Practice address
677 E Main St Ste a
Centreville, MI 49032-8525
Phone
(269) 467-1000
NPI assigned
Jul 3, 2025
Last updated
Jul 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY MENTAL HEALTH SERVICES OF ST JOSEPH COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cameron Edward Brewster Bullock
Title
Chief Executive Officer
Phone
(269) 467-1001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

677 E Main St Ste a
Centreville, MI 49032-8525

Mailing address

677 E Main St Ste a
Centreville, MI 49032-8525
Phone (269) 467-1000

Other practice location 1

1020 Millard St
Three Rivers, MI 49093-9590
Phone (269) 467-1903

Other practice location 2

1555 E Chicago Rd Ste A
Sturgis, MI 49091-1993
Phone (269) 467-1904

Other names 1

  • Pivotal Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Mental County2 organizations share this tax ID, including this one
Part of
Community Mental County

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

677 E Main St
Ste A
Centreville, MI 49032
Phone (269) 467-1001

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751500800000",
    "number": "1104715036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST STE A",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328525",
            "telephone_number": "269-467-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E MAIN ST STE A",
            "city": "CENTREVILLE",
            "state": "MI",
            "postal_code": "490328525",
            "telephone_number": "269-467-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Millard St",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490939590",
            "country_code": "US",
            "telephone_number": "269-467-1903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1555 E Chicago Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Sturgis",
            "state": "MI",
            "postal_code": "490911993",
            "country_code": "US",
            "telephone_number": "269-467-1904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY MENTAL HEALTH SERVICES OF ST JOSEPH COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MENTAL HEALTH SERVICES OF ST JOSEPH COUNTY",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "EDWARD BREWSTER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "269-467-1001"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pivotal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centreville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.