Individual ProviderCarl Glenn HagstromSocial WorkerBehavioral Health & Social Service ProvidersPractice Address342 S Ashley St, Ann Arbor, MI 48104-1351(734) 222-5040PECOS EnrollmentBased on the most recent information from CMS, provider Carl Glenn Hagstrom does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1720502883Provider TypeIndividualFull NameHagstrom, Carl GlennCredentialMSWGenderMaleSole ProprietorYesEnumeration Date7/31/2017Last Updated7/31/2017Contact InformationPractice LocationPractice Address342 S Ashley St, Ann Arbor, MI 48104-1351Phone(734) 222-5040Fax(734) 929-4415Mailing LocationMailing AddressPO Box 130223, Ann Arbor, MI 48113-0223Phone(734) 222-5040Fax(734) 929-4415Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense6801071286Michigan