1841578721 NPI number — RECOVERY INSTITUTE OF SOUTHWEST MICHIGAN, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841578721 NPI number — RECOVERY INSTITUTE OF SOUTHWEST MICHIGAN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RECOVERY INSTITUTE OF SOUTHWEST MICHIGAN, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841578721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
326 W KALAMAZOO AVE
Provider Second Line Business Mailing Address:
SUITE 311
Provider Business Mailing Address City Name:
KALAMAZOO
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49007-3361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-343-6725
Provider Business Mailing Address Fax Number:
269-343-6727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
326 W KALAMAZOO AVE
Provider Second Line Business Practice Location Address:
STE 311
Provider Business Practice Location Address City Name:
KALAMAZOO
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49007-3361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-343-6725
Provider Business Practice Location Address Fax Number:
269-343-6727
Provider Enumeration Date:
07/27/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MILLS
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
DATA ANALYST
Authorized Official Telephone Number:
269-343-6725

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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