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General NPI Number Information
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NPI Number | 1386969996
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Entity Type | Organization
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Legal Business Name | NEWAYGO COUNTY MENTAL HEALTH BOARD
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 1049 E NEWELL ST
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City | WHITE CLOUD
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State | MI
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Zip | 49349-8795
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Country | US
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Telephone | 231-689-7330
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Fax | 231-689-7345
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Provider Business Mailing Address
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Address Line | 1049 E NEWELL ST # 867
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City | WHITE CLOUD
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State | MI
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Zip | 49349-8795
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Country | US
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Telephone | 231-689-7330
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Fax | 231-689-7345
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GREG SNYDER
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Credential | ACSW
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Telephone | 231-689-7330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301045669
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License Number State | MI
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