Organization
RIPPLE EFFECTS INCLUSION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA BANTA (OFFICE ADMINISTRATOR)
(269) 845-5970
Entity
Organization
Contact information
Practice address
2255 W CENTRE AVE, PORTAGE, MI 49024-4819
(269) 257-9060
Mailing address
2255 W CENTRE AVE, PORTAGE, MI 49024-4819
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
09/09/2024
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