Organization Name: | EMPLOYEE ASSISTANCE CENTER PRAIRIE |
NPI Number: | 1013299742 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRIS SHEA (CEO) |
Mailing Address: | 3145 Prairie Grandville |
State: | MI US |
Postal Code: | 49418 |
Phone Number: | 8002270905 |
Fax Number: | 6169753565 |
NPI Enumeration Date: | 09/20/2011 |
NPI Last Update Date: | 09/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |