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818 Winifred St Jackson MI 49202-3062 | |
| (517) 513-3617 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 818 Winifred St, Jackson, Michigan |
| Authorized Official Name and Position | Matthew Smith (VICE PRESIDENT) |
| Authorized Official Contact | 5178799756 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
818 Winifred St Jackson MI 49202-3062 Ph: (517) 513-3617 | 818 Winifred St Jackson MI 49202-3062 Ph: (517) 513-3617 |
| NPI Number | 1750863858 |
|---|---|
| Provider Enumeration Date | 09/05/2018 |
| Last Update Date | 04/03/2023 |
| Certification Date | 04/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750863858 | NPI | - | NPPES |
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