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General NPI Number Information
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NPI Number | 1427803089
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Entity Type | Organization
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Legal Business Name | KALAMAZOO TC OPERATOR LLC
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Dates
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Enumeration Date | 04/18/2024
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1430 ALAMO AVE
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City | KALAMAZOO
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State | MI
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Zip | 49006-2216
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Country | US
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Telephone | 269-216-4250
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Fax | 269-585-5908
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Provider Business Mailing Address
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Address Line | 1430 ALAMO AVE
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City | KALAMAZOO
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State | MI
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Zip | 49006-2216
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Country | US
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Telephone | 609-493-4770
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Fax | 269-585-5908
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Authorized Official
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Title or Position | REIMBURSEMENT MANAGER
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Name | KELLY ANN JONES
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Credential |
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Telephone | 609-798-0887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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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 |
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License Number State |
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