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General NPI Number Information
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NPI Number | 1639407976
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Entity Type | Organization
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Legal Business Name | GOODWILL INDUSTRIES OF CENTRAL MICHIGAN'S HEARTLAND
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 4820 WAYNE RD
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City | BATTLE CREEK
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State | MI
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Zip | 49037
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Country | US
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Telephone | 269-964-9455
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Fax |
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Provider Business Mailing Address
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Address Line | 617 N. MECHANIC ST.
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City | JACKSON
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State | MI
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Zip | 49202
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Country | US
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Telephone | 517-787-0570
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Fax | 517-787-7254
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. CAROL J BUSH
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Credential |
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Telephone | 517-787-0570
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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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