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General NPI Number Information
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NPI Number | 1427569763
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Entity Type | Organization
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Legal Business Name | JOURNEY TOWARD HOPE COUNSELING
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 10/13/2017
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Provider Practice Location Address
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Address Line | 124 E PRAIRIE ST
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City | VICKSBURG
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State | MI
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Zip | 49097-1257
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Country | US
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Telephone | 269-359-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 100 BAUR LN
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City | VICKSBURG
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State | MI
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Zip | 49097-9748
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Country | US
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Telephone | 269-359-1170
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANET MARIE GLAES
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Credential | PHD, LPC
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Telephone | 269-359-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 6401004300
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License Number State | MI
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