Organization
ELLA E M BROWN CHARITABLE CIRCLE
Active
Organization
ELLA E M BROWN CHARITABLE CIRCLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUANNE K MILLER (PHYSICIAN PRACTICE DIRECTOR)
(269) 789-8814
Entity
Organization
Contact information
Practice address
200 N MADISON ST, MARSHALL, MI 49068-1143
(269) 781-4271
Mailing address
200 N MADISON ST, MARSHALL, MI 49068-1143
(269) 781-4271
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
6801089205
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801089205
LICENSE NUMBER
MI
Enumeration date
10/28/2011
Last updated
08/02/2012
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