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General NPI Number Information
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NPI Number | 1477580736
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Entity Type | Organization
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Legal Business Name | ADVANTAGE COUNSELING AND EDUCATIONAL SERVICES, INC.
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 81 N HOWARD AVE
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City | CROSWELL
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State | MI
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Zip | 48422-1222
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Country | US
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Telephone | 810-679-0200
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Fax | 810-679-0200
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Provider Business Mailing Address
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Address Line | 81 N HOWARD AVE
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City | CROSWELL
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State | MI
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Zip | 48422-1222
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Country | US
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Telephone | 810-679-0200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JERRY J HOSTERMAN
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Credential | LMSW
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Telephone | 810-679-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 6801083748
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 6801083905
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License Number State | MI
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