| Mantra Llc | |
|
826 Parchment Dr Se Ste 100 Grand Rapids MI 49546-2307 | |
| (616) 366-4226 | |
| Not Available |
| Full Name | Mantra Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 826 Parchment Dr Se Ste 100, Grand Rapids, Michigan |
| Authorized Official Name and Position | Matt Dehoog (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 6163664226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mantra Llc 326 Eastmoor Ave Se Grand Rapids MI 49546-2227 Ph: (616) 581-7687 | Mantra Llc 826 Parchment Dr Se Ste 100 Grand Rapids MI 49546-2307 Ph: (616) 366-4226 |
| NPI Number | 1932924594 |
|---|---|
| Provider Enumeration Date | 11/19/2024 |
| Last Update Date | 11/19/2024 |
| Certification Date | 11/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932924594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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