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Organization

PROJECT REHAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TOMMY HOUSE MSW (EXECUTIVE DIRECTION OF PROJECT REHA)
(616) 776-0891
Entity
Organization

Contact information

Practice address
200 EASTERN AVE SE, GRAND RAPIDS, MI 49503-4735
(616) 776-0891
(616) 776-9906
Mailing address
330 EASTERN AVE SE, GRAND RAPIDS, MI 49503-4737
(616) 776-0891
(616) 776-9906

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
410014
MI
324500000X
Substance Abuse Rehabilitation Facility
410163
MI
324500000X
Substance Abuse Rehabilitation Facility
Primary
410188
MI

Other

Enumeration date
12/12/2006
Last updated
08/22/2020
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