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General NPI Number Information
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NPI Number | 1790126290
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Entity Type | Organization
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Legal Business Name | FIRST STEPS KENT
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 118 COMMERCE AVE SW STE 300
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4106
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Country | US
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Telephone | 616-632-1003
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Fax | 616-632-1003
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Provider Business Mailing Address
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Address Line | 118 COMMERCE AVE SW STE 300
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4106
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Country | US
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Telephone | 616-632-1003
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Fax | 616-632-1003
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. REBEKAH FENNELL
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Credential |
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Telephone | 616-632-1018
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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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