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General NPI Number Information
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NPI Number | 1316286131
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Entity Type | Organization
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Legal Business Name | TOBACCO FREE PARTNERS
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Dates
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Enumeration Date | 02/14/2013
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 150 JEFFERSON AVE SE SUITE 130
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4306
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Country | US
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Telephone | 616-685-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 150 JEFFERSON AVE SE SUITE 130
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4306
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Country | US
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Telephone | 616-685-1411
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Fax |
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Authorized Official
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Title or Position | EDUCATION AND PROGRAM COORDINATOR
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Name | LAURA VAN HEEST
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Credential |
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Telephone | 616-685-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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