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818 S Crystal Ave Benton Harbor MI 49022-1618 | |
| (269) 325-8084 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 818 S Crystal Ave, Benton Harbor, Michigan |
| Authorized Official Name and Position | Marian Tripplett (CEO/FOUNDER) |
| Authorized Official Contact | 2693258084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
818 S Crystal Ave Benton Harbor MI 49022-1618 Ph: (269) 325-8084 | 818 S Crystal Ave Benton Harbor MI 49022-1618 Ph: (269) 325-8084 |
| NPI Number | 1275011603 |
|---|---|
| Provider Enumeration Date | 07/28/2018 |
| Last Update Date | 07/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275011603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801093528 (Michigan) | Primary |
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