Organization
SANFORD BEHAVIORAL HEALTH OUTPATIENT LLC
Active
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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