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Organization
WMT INC. RECOVERY & HOUSING CENTER
Active
Organization
WMT INC. RECOVERY & HOUSING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS CHURCHWELL (CEO)
(231) 728-2138
Entity
Organization
Contact information
Practice address
1823 COMMERCE ST, MUSKEGON, MI 49441-2608
(231) 728-2138
(231) 722-4771
Mailing address
2333 JARMAN ST, MUSKEGON, MI 49444-1655
(231) 739-6840
(231) 722-4771
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
SA0610022
MI
103TC0700X
Clinical Psychologist
SA0610022
MI
103TC1900X
Counseling Psychologist
SA0610022
MI
103TC2200X
Clinical Child & Adolescent Psychologist
SA0610022
MI
251B00000X
Case Management Agency
Primary
SA0610022
MI
324500000X
Substance Abuse Rehabilitation Facility
SA0610022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA2312200013009
—
MI
Enumeration date
12/13/2013
Last updated
12/13/2013
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