Organization
GLORIA CARR
Active
Organization
GLORIA CARR
Active
Other names
Gloria Carr
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA JACKSON CARR RN/LNC (RN)
(269) 491-5647
Entity
Organization
Contact information
Practice address
404 VELVET AVE, PORTAGE, MI 49002-7050
(269) 491-5647
Mailing address
404 VELVET AVE, PORTAGE, MI 49002-7050
(269) 491-5647
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
4704200513
MI
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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