Organization
FOUNTAIN HILL CENTER -- LAKESHORE OFFICE
Active
Parent organization
FOUNTAIN HILL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUNTAIN HILL CENTER
Authorized official
AMY VAN GUNST M.A., L.P.C. (EXECUTIVE COORDINATOR)
(616) 456-1178
Entity
Organization
Contact information
Practice address
534 FOUNTAIN ST NE, GRAND RAPIDS, MI 49503-3422
(616) 456-1178
Mailing address
PO BOX 32, NEW ERA, MI 49446-0032
(616) 456-1178
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MI
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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