Organization
VAN BUREN COMMUNITY MENTAL HEALTH AUTHORITY
Active
Organization
VAN BUREN COMMUNITY MENTAL HEALTH AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA L-R HESS CEO (CHIEF EXECUTIVE OFFICER)
(269) 657-5574
Entity
Organization
Contact information
Practice address
57418 COUNTY ROAD 681, SUITE C, HARTFORD, MI 49057
(269) 621-6251
(269) 621-6044
Mailing address
P.O. BOX 249, 801 HAZEN STREET, SUITE C, PAW PAW, MI 49079-0249
(269) 657-5574
(269) 657-6523
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1705298
—
MI
Enumeration date
06/11/2012
Last updated
08/13/2018
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