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General NPI Number Information
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NPI Number | 1427924398
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Entity Type | Organization
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Legal Business Name | ALPENGLOW MENTAL HEALTH
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 7950 MOORSBRIDGE RD STE 305
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City | PORTAGE
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State | MI
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Zip | 49024-4420
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Country | US
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Telephone | 269-222-2109
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Fax | 800-350-5021
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Provider Business Mailing Address
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Address Line | 7950 MOORSBRIDGE RD STE 305
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City | PORTAGE
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State | MI
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Zip | 49024-4420
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Country | US
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Telephone | 269-222-2109
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Fax | 800-350-5021
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Authorized Official
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Title or Position | PHYSICIAN/PROPRIETOR
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Name | SUZANNE HUBERTY
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Credential | MD
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Telephone | 269-222-2109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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