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General NPI Number Information
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NPI Number | 1841578721
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Entity Type | Organization
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Legal Business Name | RECOVERY INSTITUTE OF SOUTHWEST MICHIGAN, INC.
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 326 W KALAMAZOO AVE STE 311
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City | KALAMAZOO
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State | MI
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Zip | 49007-3361
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Country | US
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Telephone | 269-343-6725
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Fax | 269-343-6727
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Provider Business Mailing Address
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Address Line | 326 W KALAMAZOO AVE SUITE 311
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City | KALAMAZOO
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State | MI
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Zip | 49007-3361
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Country | US
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Telephone | 269-343-6725
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Fax | 269-343-6727
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Authorized Official
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Title or Position | DATA ANALYST
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Name | MRS. JENNIFER LYNN MILLS
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Credential | CPSS
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Telephone | 269-343-6725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | MI
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