Healthcare Provider Details

I. General information

NPI: 1982967303
Provider Name (Legal Business Name): BAY ARENAC BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N MADISON AVE
BAY CITY MI
48708-5926
US

IV. Provider business mailing address

201 MULHOLLAND ST
BAY CITY MI
48708-7693
US

V. Phone/Fax

Practice location:
  • Phone: 989-895-2240
  • Fax: 989-892-4962
Mailing address:
  • Phone: 989-895-2347
  • Fax: 989-895-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. ROBERT BLACKFORD
Title or Position: CEO
Credential:
Phone: 989-895-2347