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General NPI Number Information
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NPI Number | 1619533577
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Entity Type | Organization
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Legal Business Name | SARA MARIE RICE
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 3500 BYRON CENTER AVE SW
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City | WYOMING
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State | MI
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Zip | 49519-3260
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Country | US
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Telephone | 616-208-9337
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Fax | 616-208-9337
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Provider Business Mailing Address
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Address Line | 2566 22 MILE RD NW
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City | KENT CITY
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State | MI
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Zip | 49330-9203
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Country | US
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Telephone | 616-208-9337
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Fax | 616-208-9337
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Authorized Official
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Title or Position | OWNER
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Name | SARA MARIE RICE
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Credential | LPC
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Telephone | 616-208-9337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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