Healthcare Provider Details

I. General information

NPI: 1447162201
Provider Name (Legal Business Name): KENDALL MACARTHUR FRIDLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W WASHINGTON AVE STE 305
JACKSON MI
49201-2177
US

IV. Provider business mailing address

4536 S 2ND ST
PITTSFORD MI
49271-9400
US

V. Phone/Fax

Practice location:
  • Phone: 808-426-6521
  • Fax:
Mailing address:
  • Phone: 808-426-6521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KENDALL MACARTHUR FRIDLEY
Title or Position: LLP
Credential: MA LLP
Phone: 808-426-6521