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General NPI Number Information
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NPI Number | 1437692522
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE RECOVERY SERVICE, INC.
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 215 W MAIN ST
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City | IONIA
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State | MI
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Zip | 48846-1638
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Country | US
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Telephone | 616-522-0687
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Fax |
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Provider Business Mailing Address
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Address Line | 215 W MAIN ST PO BOX 75
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City | IONIA
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State | MI
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Zip | 48846-1638
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Country | US
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Telephone | 616-522-0687
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Fax |
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Authorized Official
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Title or Position | TREATMENT ASSESSMENT COORDINATOR
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Name | MS. HEIDI RODRIGUEZ
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Credential | M.S., CADC
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Telephone | 616-522-0687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SA0340040
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License Number State | MI
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