Organization
BASELINE CLINICAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID C. FERRY L.L.P. (PRESIDENT)
(269) 673-8525
Entity
Organization
Contact information
Practice address
43 30TH ST, ALLEGAN, MI 49010-9740
(269) 673-8525
Mailing address
38175 32ND ST, PAW PAW, MI 49079-8444
(269) 673-8525
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AS030258948
MI
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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