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General NPI Number Information
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NPI Number | 1841413325
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Entity Type | Organization
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Legal Business Name | CHOICES WEST COUNSELING SERVICES, INC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 49 S STATE ST SUITE A
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City | HART
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State | MI
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Zip | 49420-1196
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Country | US
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Telephone | 231-873-1443
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Fax | 231-873-9201
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Provider Business Mailing Address
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Address Line | 49 S STATE ST SUITE A
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City | HART
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State | MI
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Zip | 49420-1196
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Country | US
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Telephone | 231-873-1443
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Fax | 231-873-9201
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRUCE CARSON VANDERHOOF
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Credential | CAC-M
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Telephone | 231-873-1443
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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 | 640010
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License Number State | MI
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