Organization
WEDGWOOD CHRISTIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL T GOWDY ED D, CFRE (CEO/PRESIDENT)
(616) 942-2110
Entity
Organization
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
(616) 942-0589
Mailing address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
(616) 942-0589
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
CI410201082
MI
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
CI410201226
MI
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
CI410201359
MI
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
CI410201501
MI
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
CICI410201003
MI
3245S0500X
Children's Substance Abuse Rehabilitation Facility
CI410201502
MI
Other
Enumeration date
09/28/2006
Last updated
11/04/2024
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