Organization
WEST MICHIGAN THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS CHURCHWELL BS, CACII, ICA, C-2 (CHIEF EXECUTIVE OFFICER)
(231) 728-2138
Entity
Organization
Contact information
Practice address
130 E APPLE AVE, MUSKEGON, MI 49442-3405
(231) 728-2138
Mailing address
130 E APPLE AVE, MUSKEGON, MI 49442-3405
(231) 728-2138
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
610022
MI
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
610050
MI
Other
Enumeration date
05/16/2007
Last updated
02/22/2010
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