# BLUE WATER CENTER FOR INDEPENDENT LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083790810
- **Authorized official:** PATRICK BROWN (CLINICAL DIRECTOR)
- **Authorized official phone:** (810) 987-9337

## Contact information

- **Practice address:** 310 WATER ST, PORT HURON, MI 48060-5431
- **Practice address phone:** (810) 987-9337
- **Mailing address:** 310 WATER ST, PORT HURON, MI 48060-5431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 06/13/2016