Healthcare Provider Details

I. General information

NPI: 1629988399
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: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 E JOLLY RD
LANSING MI
48910-6825
US

IV. Provider business mailing address

812 E JOLLY RD. SUITE 210
LANSING MI
48910-6818
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TERRI JENNESS
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 517-256-4231