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General NPI Number Information
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NPI Number | 1518053347
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Entity Type | Organization
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Legal Business Name | BURNHAM BROOK
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 200 W MICHIGAN AVE
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City | BATTLE CREEK
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State | MI
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Zip | 49017
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Country | US
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Telephone | 269-966-2475
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Fax | 269-966-2493
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Provider Business Mailing Address
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Address Line | 200 W MICHIGAN AVE
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City | BATTLE CREEK
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State | MI
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Zip | 49017
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Country | US
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Telephone | 269-966-2475
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Fax | 269-966-2493
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Authorized Official
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Title or Position | CEO
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Name | MRS. KARLA ANN FALES
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Credential |
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Telephone | 800-626-6719
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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 |
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License Number State |
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