Organization
IRON COUNTY SAMARITAN SERVICES, INC.
Active
Other names
Samaritan Counseling Centers of the U.P.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DORRINGTON VAN DOREN JR. L.M.S.W. (EXECUTIVE DIRECTOR)
(906) 265-2000
Entity
Organization
Contact information
Practice address
117 W GENESEE ST, SUITE 9, IRON RIVER, MI 49935-1497
(906) 265-2000
Mailing address
117 W GENESEE ST, SUITE 9, IRON RIVER, MI 49935-1497
(906) 265-2000
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
2574-123
WI
251S00000X
Community/Behavioral Health Agency
Primary
L112776
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COUN10-99131
COUNSELING SERVICES CONTRACT (CM-F910)
MI
Enumeration date
04/28/2010
Last updated
04/28/2010
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