Organization
RENEWAL CHRISTIAN COUNSELING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ABIGAIL R MILLER (OFFICE MANAGER)
(586) 783-2950
Entity
Organization
Contact information
Practice address
3847 PINE GROVE AVE STE B, FORT GRATIOT, MI 48059-4265
(810) 966-0099
(810) 696-7339
Mailing address
3847 PINE GROVE AVE STE B, FORT GRATIOT, MI 48059-4265
(810) 966-0099
(810) 696-7339
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094186
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
05/08/2008
Last updated
12/06/2017
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