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General NPI Number Information
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NPI Number | 1871823476
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Entity Type | Organization
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Legal Business Name | BEST WAY PROVIDERS, INC.
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 2035 108TH AVE
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City | OTSEGO
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State | MI
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Zip | 49078-9750
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Country | US
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Telephone | 269-692-2778
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Fax | 269-692-2778
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Provider Business Mailing Address
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Address Line | 17 DELAWARE AVE
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City | MUSKEGON
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State | MI
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Zip | 49442-3308
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Country | US
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Telephone | 231-728-2208
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Fax | 231-728-0187
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STEPHEN DOUGLAS KACMAR
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Credential |
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Telephone | 231-728-2208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | AS030010145
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License Number State | MI
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