Healthcare Provider Details

I. General information

NPI: 1942695523
Provider Name (Legal Business Name): AMBER RECTOR CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 WRIGHT LN
MARSHALL MI
49068-9612
US

IV. Provider business mailing address

748 WRIGHT LN
MARSHALL MI
49068-9612
US

V. Phone/Fax

Practice location:
  • Phone: 269-274-3531
  • Fax:
Mailing address:
  • Phone: 269-274-3531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: