| West Side Family Mental Health Clinic, P.c. | |
|
352 Blue Star Hwy Blue Star Professional Bldg. South Haven MI 49090-7102 | |
| (269) 637-1170 | |
| (269) 639-1312 |
| Full Name | West Side Family Mental Health Clinic, P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 352 Blue Star Hwy, South Haven, Michigan |
| Authorized Official Name and Position | Adolph O. Di Loreto (PRESIDENT) |
| Authorized Official Contact | 2696371170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Side Family Mental Health Clinic, P.c. 352 Blue Star Hwy Blue Star Professional Bldg. South Haven MI 49090-7102 Ph: (269) 637-1170 | West Side Family Mental Health Clinic, P.c. 352 Blue Star Hwy Blue Star Professional Bldg. South Haven MI 49090-7102 Ph: (269) 637-1170 |
| NPI Number | 1194918466 |
|---|---|
| Provider Enumeration Date | 08/21/2007 |
| Last Update Date | 09/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194918466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0822 (Michigan) | Primary |
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