Organization Name: | COUNSELING AND CONSULTATION RESOURCES |
NPI Number: | 1013060151 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRENT MICHAEL ELLENS (PRESIDENT) |
Mailing Address: | 720 E 8th St Suite 2 Holland |
State: | MI US |
Postal Code: | 494233079 |
Phone Number: | 6163550549 |
Fax Number: | 6163550480 |
NPI Enumeration Date: | 01/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 6301011810 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |