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General NPI Number Information
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NPI Number | 1760851240
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Entity Type | Organization
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Legal Business Name | G & H ENTERPRISES, LLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 950 28TH ST SE STE E-103
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-6166
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Country | US
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Telephone | 248-909-7202
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Fax | 616-805-4165
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Provider Business Mailing Address
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Address Line | 4254 LAMDALE CT SE APRT B-1
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2403
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Country | US
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Telephone | 248-909-7202
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Fax | 616-805-4165
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Authorized Official
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Title or Position | CEO/DIRECOR
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Name | MR. JOSEPH EUGENE MOJET
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Credential | LMSW
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Telephone | 248-909-7202
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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 | 6801072469
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License Number State | MI
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