Organization
CENTRIA HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECKA TODD (BEHAVIOR TECH)
(248) 282-3105
Entity
Organization
Contact information
Practice address
1477 BURKE AVE NE APT B, GRAND RAPIDS, MI 49505-5366
(248) 282-3105
Mailing address
1477 BURKE AVE NE APT B, GRAND RAPIDS, MI 49505-5366
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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