Healthcare Provider Details

I. General information

NPI: 1265483457
Provider Name (Legal Business Name): COMMUNITY MENTAL HEALTH AUTHORITY OF CLINTON EATON INGHAM COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 E JOLLY ROAD
LANSING MI
48910-6821
US

IV. Provider business mailing address

812 E JOLLY ROAD SUITE 210
LANSING MI
48910-6821
US

V. Phone/Fax

Practice location:
  • Phone: 517-346-8200
  • Fax: 517-346-8291
Mailing address:
  • Phone: 517-346-8119
  • Fax: 517-346-8291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SARA LURIE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 517-346-8212