Organization
LAKEVIEW CHILD & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN BULTMAN MA LLPC (OWNER/DIRECTOR)
(616) 240-3023
Entity
Organization
Contact information
Practice address
6630 GRAN VIA CT NE, ROCKFORD, MI 49341-9692
(616) 240-3023
Mailing address
6630 GRAN VIA CT NE, ROCKFORD, MI 49341-9692
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
MI
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/17/2013
Last updated
12/28/2013
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