Organization
WEST MICHIGAN ADDICTION CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS LAMOTT HAYNES M.D. (PRESIDENT)
(616) 365-8800
Entity
Organization
Contact information
Practice address
3001 FULLER AVE NE, SUITE 1, GRAND RAPIDS, MI 49505-3204
(616) 365-8800
(616) 365-7979
Mailing address
3001 FULLER AVE NE, SUITE 1, GRAND RAPIDS, MI 49505-3204
(616) 365-8800
(616) 365-7979
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
410128
MI
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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