Healthcare Provider Details

I. General information

NPI: 1124462437
Provider Name (Legal Business Name): VERITAS INTEGRATED PSYCHIATRIC CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3265 WALKER AVE NW SUITE D
GRAND RAPIDS MI
49544-9708
US

IV. Provider business mailing address

3265 WALKER AVE NW SUITE D
GRAND RAPIDS MI
49544-9708
US

V. Phone/Fax

Practice location:
  • Phone: 616-608-5457
  • Fax:
Mailing address:
  • Phone: 616-608-5457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301079422
License Number StateMI

VIII. Authorized Official

Name: DR. JEFFREY JOHN VRIELINK
Title or Position: SOLE PROPRIETOR
Credential: M.D.
Phone: 616-608-5457