Organization
SANFORD WEST LLC
Active
Other names
Sanford West Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ROBINSON TALBERT (CREDENTIALING & CONTRACTING MGR)
(616) 520-9074
Entity
Organization
Contact information
Practice address
15146 16TH AVE, MARNE, MI 49435-9605
(616) 288-6970
(616) 279-3955
Mailing address
15146 16TH AVE, MARNE, MI 49435-9605
(616) 288-6970
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
11/02/2022
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