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General NPI Number Information
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NPI Number | 1487271250
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Entity Type | Organization
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Legal Business Name | POINT 21 RECOVERY LLC
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Dates
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Enumeration Date | 06/28/2020
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 3417 EASTERN AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-2406
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Country | US
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Telephone | 231-301-1102
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Fax |
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Provider Business Mailing Address
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Address Line | 3417 EASTERN AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-2406
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Country | US
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Telephone | 616-855-6402
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Fax | 616-855-6406
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Authorized Official
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Title or Position | MEMBER
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Name | MS. CINDY PIERCE
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Credential |
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Telephone | 616-855-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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