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General NPI Number Information
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NPI Number | 1114342581
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL REHABILITATION SERVICES, INC.
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Dates
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Enumeration Date | 02/21/2014
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 355 W MANNSIDING RD
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City | HARRISON
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State | MI
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Zip | 48625-9564
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Country | US
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Telephone | 989-539-5350
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Fax |
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Provider Business Mailing Address
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Address Line | 355 W MANNSIDING RD
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City | HARRISON
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State | MI
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Zip | 48625-9564
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Country | US
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Telephone | 989-539-5350
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | STACY POWELL
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Credential |
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Telephone | 269-704-7563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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