Healthcare Provider Details

I. General information

NPI: 1811264773
Provider Name (Legal Business Name): COMPREHENSIVE RECOVERY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W MAIN ST
IONIA MI
48846-1638
US

IV. Provider business mailing address

PO BOX 75
IONIA MI
48846-0075
US

V. Phone/Fax

Practice location:
  • Phone: 616-522-0687
  • Fax: 616-522-0725
Mailing address:
  • Phone: 616-522-0687
  • Fax: 616-522-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301014418
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberSA0340040
License Number StateMI

VIII. Authorized Official

Name: JASON MICHAEL FLOHR
Title or Position: CLINICAL DIRECTOR
Credential: MA, LPC, CAADC
Phone: 616-522-0687