Organization
J. E. RYAN ENTERPRISE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ERNEST RYAN LMSW, LPC (PRESIDENT)
(810) 743-8316
Entity
Organization
Contact information
Practice address
G 4511 MILLER RD, FLINT, MI 48507-1107
(810) 720-3120
(810) 742-2920
Mailing address
4511 MILLER RD, FLINT, MI 48507-1107
(810) 720-3120
(810) 742-2920
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801010818
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N72800
MEDICARE
MI
Enumeration date
09/21/2010
Last updated
09/21/2010
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