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Organization
KAB MI ENTERPRISES LLC
Active
Organization
KAB MI ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9797
Entity
Organization
Contact information
Practice address
2111 UNIVERSITY PARK DR STE 400, OKEMOS, MI 48864-6907
(517) 917-4035
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704294815
MI
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
02/20/2018
Last updated
06/03/2025
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