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General NPI Number Information
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NPI Number | 1619206513
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PEER SERVICES
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 12/24/2009
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Provider Practice Location Address
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Address Line | 316 S MARTIN L KING BLVD # 2
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City | LANSING
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State | MI
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Zip | 48915
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Country | US
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Telephone | 517-316-9033
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Fax |
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Provider Business Mailing Address
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Address Line | 316 S MARTIN L KING BLVD # 2
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City | LANSING
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State | MI
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Zip | 48915
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | MICHELLE BIDIGARE
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Credential | C.P.S.S.
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Telephone | 517-316-9033
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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 |
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License Number State |
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