Organization
JACKSON-HILLSDALE COMMUNITY MENTAL HEALTH BOARD
Active
Other names
LIFEWAYS
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIBETH LEONARD (CHIEF EXECUTIVE OFFICER)
(517) 789-1208
Entity
Organization
Contact information
Practice address
1200 N. WEST AVENUE, JACKSON, MI 49202
(517) 789-1209
(517) 796-4532
Mailing address
1200 N. WEST AVENUE, JACKSON, MI 49202
(517) 780-3332
(517) 796-4532
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C87612
MEDICARE ID
MI
05
—
1712229
—
MI
05
—
171229
—
MI
Enumeration date
06/07/2010
Last updated
07/17/2024
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