Organization
BLUE SEAHORSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE GEORGE SIVER (CHAIRMAN OF THE BOARD)
(269) 244-3577
Entity
Organization
Contact information
Practice address
101 E DELAWARE ST, DECATUR, MI 49045-1131
(269) 244-3577
(269) 409-3983
Mailing address
101 E DELAWARE ST, DECATUR, MI 49045-1131
(269) 244-3577
(269) 409-3983
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
SA0800033
MI
101YM0800X
Mental Health Counselor
Primary
SA0800033
MI
Other
Enumeration date
06/26/2014
Last updated
07/16/2014
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