Healthcare Provider Details

I. General information

NPI: 1174056725
Provider Name (Legal Business Name): UNITED RESOLUTION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9883 SAND LAKE HWY
ONSTED MI
49265-9546
US

IV. Provider business mailing address

9883 SAND LAKE HWY
ONSTED MI
49265-9546
US

V. Phone/Fax

Practice location:
  • Phone: 517-215-4243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6801099246
License Number StateMI

VIII. Authorized Official

Name: ERIKA BEHM
Title or Position: THERAPIST
Credential: L.L.M.S.W.
Phone: 517-215-4243