| Cted Llc | |
|
1003 Parchment Dr Se Grand Rapids MI 49546-3664 | |
| (616) 957-7700 | |
| (616) 957-7773 |
| Full Name | Cted Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1003 Parchment Dr Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Stephanie Robinson (CREDENTIALING CONTACT) |
| Authorized Official Contact | 2397916363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cted Llc 1003 Parchment Dr Se Grand Rapids MI 49546-3664 Ph: (616) 957-7700 | Cted Llc 1003 Parchment Dr Se Grand Rapids MI 49546-3664 Ph: (616) 957-7700 |
| NPI Number | 1356392880 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 05/21/2021 |
| Certification Date | 05/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356392880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
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