Healthcare Provider Details

I. General information

NPI: 1720925696
Provider Name (Legal Business Name): REGULATED MIND AND WELLNESS STAFFING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 LAKESIDE DR
PERRINTON MI
48871-9632
US

IV. Provider business mailing address

9343 LAKESIDE DR
PERRINTON MI
48871-9632
US

V. Phone/Fax

Practice location:
  • Phone: 616-727-0496
  • Fax:
Mailing address:
  • Phone: 616-727-0496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LAVONNA LYNNSILEE ALVERA
Title or Position: NP
Credential: NP
Phone: 517-420-2221