Healthcare Provider Details

I. General information

NPI: 1477500411
Provider Name (Legal Business Name): MRC INDUSTRIES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 05/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 S BURDICK ST
KALAMAZOO MI
49001-2712
US

IV. Provider business mailing address

2538 SOUTH 26TH STREET
KALAMAZOO MI
49048
US

V. Phone/Fax

Practice location:
  • Phone: 269-343-0747
  • Fax: 269-343-2007
Mailing address:
  • Phone: 269-343-0747
  • Fax: 269-343-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRIS A. ZEIGLER
Title or Position: PRESIDENT
Credential:
Phone: 269-343-0747