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NPI Code Detail

MEDICARE: INTERACT OF MICHIGAN, INC

MEDICARE: INTERACT OF MICHIGAN, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760419691
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERACT OF MICHIGAN, INC
Provider Business Mailing Address
First Line : 610 SOUTH BURDICK ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-5221
Country : US
Telephone Number : 269-381-3700
Fax Number : 269-381-3810
Provider Business Practice Location Address
First Line : 610 SOUTH BURDICK ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-5221
Country : US
Telephone Number : 269-381-3700
Fax Number : 269-381-3810
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : HEATHER PARKER
Credential :
Telephone Number : 269-381-3700
Provider Enumeration Date : 06/27/2006
Last Update Date : 07/29/2019

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610 S BURDICK ST
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1376578989 — NANCY M MCDONALD LMSW
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49007-5221
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KALAMAZOO, MI
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1750490942 — RANDALL WOLBERT LMSW
Practice Location Address:
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Directions to “INTERACT OF MICHIGAN, INC ” Practice Location

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