Healthcare Provider Details

I. General information

NPI: 1184452963
Provider Name (Legal Business Name): TAPESTRY PSYCHIATRIC STAFFING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2774 BIRCHCREST DR SE
GRAND RAPIDS MI
49506-5477
US

IV. Provider business mailing address

1861 LOCKMERE DR SE
KENTWOOD MI
49508-6319
US

V. Phone/Fax

Practice location:
  • Phone: 616-381-3003
  • Fax:
Mailing address:
  • Phone: 219-929-8385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KARLI RENEE REICH
Title or Position: OWNER
Credential: PMHNP
Phone: 219-929-8385