| Bases Recovery Center | |
|
101 M 66 N Charlevoix MI 49720-9338 | |
| (231) 547-1144 | |
| (231) 547-4970 |
| Full Name | Bases Recovery Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 101 M 66 N, Charlevoix, Michigan |
| Authorized Official Name and Position | Celia Partida Kelly (PROGRAM DIRECTOR) |
| Authorized Official Contact | 2315471144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bases Recovery Center 101 M 66 N Charlevoix MI 49720-9338 Ph: (231) 547-1144 | Bases Recovery Center 101 M 66 N Charlevoix MI 49720-9338 Ph: (231) 547-1144 |
| NPI Number | 1790053270 |
|---|---|
| Provider Enumeration Date | 12/12/2011 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Medicare PECOS PAC ID | 5193023000 |
|---|---|
| Medicare Enrollment ID | O20240109004015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790053270 | NPI | - | NPPES |
| MNPC20131030 | Other | MI | MCLAREN HEALTH PLAN, MCLAREN MEDICAID, MCLAREN HMO, MCLAREN HEALTH ADVANTAGE |
| OA50082 | Other | MI | BCBSM MENTAL HEALTH AND SUBSTANCE ABUSE |
| MIS601220445 | Other | MI | MAGELLAN |
| 383SYS0617-C | Other | MI | HUMANA BEHAVIORAL HEALTH |
| MIS601220444 | Other | MI | MAGELLAN |
| COUN18-99599 | Other | MI | MDHHS |
| MIS601220443 | Other | MI | MAGELLAN |
| 20151209439760 | Medicaid | MI | |
| OA50082 | Other | MI | BLUE CROSS BLUE SHIELD, TRADITIONAL (10) PAR, PPO TRUST (55) |
| 000722974 | Other | MI | OPTUM |
| Provider Name | Celia Partida Kelly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053795062 PECOS PAC ID: 0547568453 Enrollment ID: I20240109004081 |
| Provider Name | Leah M Mayotte |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760866776 PECOS PAC ID: 4981056744 Enrollment ID: I20240117001332 |
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