Organization
SANFORD WEST LLC
Active
Parent organization
SANFORD WEST LLC
Other names
Sanford West Behavioral Health Services ED
Organization subpart
Yes
Provider details
NPI number
Legal business name
SANFORD WEST LLC
Authorized official
STEPHANIE ROBINSON TALBERT (CREDENTIALING & CONTRACTING MANAGE)
(616) 520-9074
Entity
Organization
Contact information
Practice address
15146 16TH AVE, MARNE, MI 49435-9605
(616) 288-6970
Mailing address
15146 16TH AVE, MARNE, MI 49435-9605
(616) 288-6970
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
11/02/2022
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