Organization
KEWEENAW BAY INDIAN COMMUNITY SUBSTANCE ABUSE PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY LEE CURTIS CAC-1 (ADMINISTRATOR)
(906) 524-4411
Entity
Organization
Contact information
Practice address
16025 BREWERY RD, LANSE, MI 49946-8092
(906) 524-4411
(906) 524-4415
Mailing address
PO BOX 69, LANSE, MI 49946-0069
(906) 524-4411
(906) 524-4415
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
0700001
MI
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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