Organization
JAQUALE RHODES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAQUALE RHODES (INDEPENDENT CONTRACTOR)
(616) 259-2397
Entity
Organization
Contact information
Practice address
349 JACKSON AVE, MUSKEGON, MI 49442-1114
(616) 259-2397
Mailing address
349 JACKSON AVE, MUSKEGON, MI 49442-1114
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77498
INDEPENDENT CONTRACTOR
MI
Enumeration date
04/10/2017
Last updated
04/10/2017
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