<unavail> in Grand Rapids, MI - Medicare Clinic/Center

is a medicare enrolled mental health clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Grand Rapids, Michigan. The current practice location for is 2055 Rosewood Ave Se, Grand Rapids, Michigan. For appointments, you can reach them via phone at (616) 776-5110. The mailing address for is 100 Cherry St Se, Grand Rapids, Michigan and phone number is (616) 965-8200.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1124187471. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (616) 776-5110.

Contact Information


	2055 Rosewood Ave Se Grand Rapids MI 49506-5248
	(616) 776-5110
	(616) 776-5111

Map and Direction

Mental Health Clinic Profile

Full Name
Speciality	Clinic/Center
Location	2055 Rosewood Ave Se, Grand Rapids, Michigan
Authorized Official Name and Position	Tasha Blackmon (CEO)
Authorized Official Contact	6169658215
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
100 Cherry St Se Grand Rapids MI 49503-4526 Ph: (616) 965-8200	2055 Rosewood Ave Se Grand Rapids MI 49506-5248 Ph: (616) 776-5110

NPI Details:

NPI Number	1124187471
Provider Enumeration Date	12/06/2006
Last Update Date	08/25/2023
Certification Date	08/25/2023

Medicare PECOS Information:

Medicare PECOS PAC ID	6800707647
Medicare Enrollment ID	O20131205001914

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124187471	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
104100000X	Social Worker	(Michigan)	Secondary
122300000X	Dentist	(* (Not Available))	Secondary
207Q00000X	Family Medicine	(* (Not Available))	Secondary
208000000X	Pediatrics	(* (Not Available))	Secondary
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Grand Rapids, MI

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- Medicare Mental Health Clinic in Grand Rapids, MI