| |
100 Malton Rd Suites 1, 2, 3, 4, 5, 6, 7, & 8 Negaunee MI 49866 | |
(906) 464-0002 | |
(906) 464-4043 |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 100 Malton Rd, Negaunee, Michigan |
Authorized Official Name and Position | Greg Miles Toutant (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9062289699 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Malton Rd Negaunee MI 49866-2001 Ph: (906) 228-9699 | 100 Malton Rd Suites 1, 2, 3, 4, 5, 6, 7, & 8 Negaunee MI 49866 Ph: (906) 464-0002 |
NPI Number | 1104571900 |
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Provider Enumeration Date | 02/21/2022 |
Last Update Date | 11/04/2024 |
Certification Date | 11/04/2024 |
Identifier | Type | State | Issuer |
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1104571900 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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