Healthcare Provider Details

I. General information

NPI: 1578498416
Provider Name (Legal Business Name): PIVOT POINT YOUTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58511 NORTON ST
MATTAWAN MI
49071-7601
US

IV. Provider business mailing address

58511 NORTON ST
MATTAWAN MI
49071-7601
US

V. Phone/Fax

Practice location:
  • Phone: 269-718-7538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY M DENAWAY
Title or Position: OWNER/MANAGING MEMBER
Credential:
Phone: 269-718-7538