MEDICARE: REACH FOR RECOVERY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker
3	171M00000X	Case Manager/Care Coordinator
4	175T00000X	Peer Specialist
5	2083A0300X	Addiction Medicine (Preventive Medicine) Physician
6	261QM0850X	Adult Mental Health Clinic/Center
7	261QM0855X	Adolescent and Children Mental Health Clinic/Center
8	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
9	363A00000X	Physician Assistant
10	363L00000X	Nurse Practitioner
11	251K00000X	Public Health or Welfare Agency	700025	MI

General Provider Information

NPI Number	:	1679653810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACH FOR RECOVERY, INC.

Provider Business Mailing Address
First Line	:	700 WASHINGTON AVE
Second Line	:	SUITE 220
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-1499
Country	:	US
Telephone Number	:	616-842-6710
Fax Number	:	616-842-6710

Provider Business Practice Location Address
First Line	:	700 WASHINGTON AVE STE 220
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-1462
Country	:	US
Telephone Number	:	616-842-6710
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MELINDA JURRIES
Credential	:
Telephone Number	:	616-396-5284

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/14/2023

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