Healthcare Provider Details
I. General information
NPI: 1881906782
Provider Name (Legal Business Name): NEW COMMUNITY RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2010
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5030 NORTHWIND DR STE 108
EAST LANSING MI
48823-5034
US
IV. Provider business mailing address
1031 E SAGINAW ST
LANSING MI
48906-5519
US
V. Phone/Fax
- Phone: 517-336-4335
- Fax: 517-487-0101
- Phone: 517-487-9642
- Fax: 517-487-1129
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
MASSOLL
Title or Position: PRESIDENT
Credential:
Phone: 517-336-4335