Organization
GREAT LAKES BEHAVIORAL HEALTH PLC
Active
Organization
GREAT LAKES BEHAVIORAL HEALTH PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VANDER VELDE DO (OWNER)
(616) 920-1816
Entity
Organization
Contact information
Practice address
678 FRONT AVE NW, SUITE 365, GRAND RAPIDS, MI 49504-5325
(616) 920-1816
Mailing address
678 FRONT AVE NW, SUITE 365, GRAND RAPIDS, MI 49504-5325
(616) 920-1816
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/26/2015
Last updated
06/02/2015
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