Healthcare Provider Details

I. General information

NPI: 1710721527
Provider Name (Legal Business Name): ARBOR MIND PSYCHIATRY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/25/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2624 DANBURY LN
ANN ARBOR MI
48103-2278
US

IV. Provider business mailing address

625 KENMOOR AVE SE
GRAND RAPIDS MI
49546-2395
US

V. Phone/Fax

Practice location:
  • Phone: 248-760-0501
  • Fax:
Mailing address:
  • Phone: 248-760-0501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER SPRAGUE
Title or Position: OWNER, OPERATOR
Credential: MD
Phone: 248-760-0501