Organization
SANFORD BEHAVIORAL HEALTH OUTPATIENT LLC
Active
Other names
Sanford Behavioral Health Outpatient LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE ROBINSON (CREDENTIALING & CONTRACTING MANAGER)
(616) 520-9074
Entity
Organization
Contact information
Practice address
15146 16TH AVE, MARNE, MI 49435-9605
(844) 776-9651
Mailing address
15146 16TH AVE, MARNE, MI 49435-9605
(844) 776-9651
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/29/2022
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