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General NPI Number Information
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NPI Number | 1831437920
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Entity Type | Organization
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Legal Business Name | PREMIER PLUS CARE, INC.
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 532 ANDOVER ST SE
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City | KENTWOOD
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State | MI
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Zip | 49548-7607
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Country | US
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Telephone | 616-551-3460
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Fax |
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Provider Business Mailing Address
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Address Line | 39633 SPRINGWATER DR
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City | NORTHVILLE
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State | MI
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Zip | 48168-3963
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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 | PRESIDENT
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Name | STEPHEN HENDRIX
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Credential |
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Telephone | 616-551-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | AS410314327
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License Number State | MI
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