Organization
CENTRE A MENTAL HEALTH ORGANIZATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R MICHURA JR. (MANAGER)
(616) 935-2151
Entity
Organization
Contact information
Practice address
622 E SAVIDGE ST STE 5, SPRING LAKE, MI 49456-1957
(616) 935-2151
(616) 469-1822
Mailing address
2319 BLOOMFIELD CT, NORTON SHORES, MI 49441-4472
(616) 633-1767
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802942512
LARA
MI
Enumeration date
12/19/2022
Last updated
01/17/2023
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