Organization
DOMESTIC VIOLENCE ALTERNATIVE PROGRAM LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN CLARK BAILEY LMSW (DIRECTOR)
(517) 215-1798
Entity
Organization
Contact information
Practice address
131 S WINTER ST, ADRIAN, MI 49221-2602
(517) 215-1798
Mailing address
131 S WINTER ST, ADRIAN, MI 49221-2602
(517) 215-1798
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1033348925
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033348925
—
MI
Enumeration date
01/02/2014
Last updated
01/02/2014
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