Healthcare Provider Details

I. General information

NPI: 1861430381
Provider Name (Legal Business Name): BRANCH COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 VISTA DR
COLDWATER MI
49036
US

IV. Provider business mailing address

200 VISTA DR
COLDWATER MI
49036-1776
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-2129
  • Fax: 517-279-8172
Mailing address:
  • Phone: 517-278-2129
  • Fax: 517-279-8172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBBIN SUE WILBER
Title or Position: FINANCE OFFICER
Credential: BBA
Phone: 517-278-2129