Organization
SHORELINE CONSULTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK E. RANKIN LMSW (EXECUTIVE DIRECTOR)
(231) 733-5334
Entity
Organization
Contact information
Practice address
1435 PECK ST, MUSKEGON, MI 49441-2125
(231) 733-5334
(231) 737-1255
Mailing address
1435 PECK ST, MUSKEGON, MI 49441-2125
(231) 733-5334
(231) 737-1255
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
610042
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610042
SUBSTANCE ABUSE LICENSE
MI
Enumeration date
08/11/2006
Last updated
05/30/2008
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