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General NPI Number Information
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NPI Number | 1255386124
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Entity Type | Organization
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Legal Business Name | MID-MICHIGAN RECOVERY SERVICES, INC.
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 913 W HOLMES RD SUITE 200
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City | LANSING
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State | MI
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Zip | 48910-0426
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Country | US
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Telephone | 517-887-0226
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Fax | 517-887-8121
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Provider Business Mailing Address
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Address Line | 913 W HOLMES RD SUITE 200
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City | LANSING
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State | MI
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Zip | 48910-0426
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Country | US
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Telephone | 517-887-0226
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Fax | 517-887-8121
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PATRICK PATTERSON
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Credential |
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Telephone | 517-887-0226
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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 | 330011
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 330021
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 330001
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License Number State | MI
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