Organization
BLUE HORIZON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH PHILIP SMITHSON LMSW (THERAPIST)
(906) 322-6277
Entity
Organization
Contact information
Practice address
501 W HARRIE ST, NEWBERRY, MI 49868-1226
(906) 322-6277
Mailing address
501 W HARRIE ST, NEWBERRY, MI 49868-1226
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801086974
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770635427
NPI - INDIVIDUAL
MI
Enumeration date
04/20/2013
Last updated
04/20/2013
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