Organization
PARENT TO PARENT OF SW MI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDIDA BUSH (EXECUTIVE DIRECTOR)
(269) 345-8950
Entity
Organization
Contact information
Practice address
406 E MICHIGAN AVE, KALAMAZOO, MI 49007-3888
(269) 345-8950
Mailing address
406 E MICHIGAN AVE, KALAMAZOO, MI 49007-3888
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
MI
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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