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602 W Michigan Ave Jackson MI 49202 | |
| (517) 783-5334 | |
| (571) 783-6064 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 602 W Michigan Ave, Jackson, Michigan |
| Authorized Official Name and Position | Dian Kay Breining (CEO) |
| Authorized Official Contact | 5177835334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
602 W Michigan Ave Jackson MI 49202 Ph: (517) 783-5334 | 602 W Michigan Ave Jackson MI 49202 Ph: (517) 783-5334 |
| NPI Number | 1881718906 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 10/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881718906 | NPI | - | NPPES |
| 0C80042 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| 1881718906 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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