Organization
ST JOHNS HOME
Active
Organization
ST JOHNS HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY JOHNSON MSW (PROGRAM ADMINISTRATOR)
(616) 235-2090
Entity
Organization
Contact information
Practice address
2355 KNAPP ST NE, GRAND RAPIDS, MI 49505-4415
(616) 235-2090
(616) 235-2099
Mailing address
PO BOX 120125, GRAND RAPIDS, MI 49528-0103
(616) 235-2090
(616) 235-2099
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
08/22/2020
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