Organization
KALAMAZOO COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD R SOVA JR. (IT DIRECTOR)
(269) 553-8000
Entity
Organization
Contact information
Practice address
3299 GULL RD, W1F4, KALAMAZOO, MI 49048
(269) 553-8000
(269) 553-8012
Mailing address
3299 GULL RD, PO BOX63, W1F4, KALAMAZOO, MI 49048-1281
(269) 553-8000
(269) 553-8012
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
390177
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390177
SUBSTANCE ABUSE LICENSE#
MI
Enumeration date
06/13/2012
Last updated
06/13/2012
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