| Rivers Edge Recovery Center Of Michigan Llc | |
|
916 Washington Ave Ste 205 Bay City MI 48708-5721 | |
| (989) 415-3143 | |
| (989) 391-4412 |
| Full Name | Rivers Edge Recovery Center Of Michigan Llc |
|---|---|
| Speciality | Social Worker |
| Location | 916 Washington Ave Ste 205, Bay City, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivers Edge Recovery Center Of Michigan Llc Po Box 10 Mason MI 48854-0010 Ph: (517) 676-9788 | Rivers Edge Recovery Center Of Michigan Llc 916 Washington Ave Ste 205 Bay City MI 48708-5721 Ph: (989) 415-3143 |
| NPI Number | 1033619572 |
|---|---|
| Provider Enumeration Date | 02/20/2018 |
| Last Update Date | 02/20/2018 |
| Medicare PECOS PAC ID | 6800157041 |
|---|---|
| Medicare Enrollment ID | O20180302000752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033619572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801068319 (Michigan) | Primary |
| Provider Name | Darneal M Mcallister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790894756 PECOS PAC ID: 3375541899 Enrollment ID: I20061117000045 |
| Provider Name | Corinn L Denay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427427970 PECOS PAC ID: 1951691484 Enrollment ID: I20160613000103 |
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