Healthcare Provider Details

I. General information

NPI: 1740104629
Provider Name (Legal Business Name): MIDWEST BEHAVIORAL HEALTH CENTER II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E POTTAWATAMIE ST
TECUMSEH MI
49286-2018
US

IV. Provider business mailing address

500 E POTTAWATAMIE ST
TECUMSEH MI
49286-2018
US

V. Phone/Fax

Practice location:
  • Phone: 888-262-8310
  • Fax: 888-289-2310
Mailing address:
  • Phone: 888-262-8310
  • Fax: 888-289-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KENNETH WEBER
Title or Position: CEO
Credential:
Phone: 419-290-8884