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Mr. Larry Wayne Edwards, BS
Substance Abuse Rehabilitation Facility in Benton Harbor, Michigan
NPI 1184375016

Larry Wayne Edwards is a Substance Abuse Rehabilitation Facility based in Benton Harbor, MI. Larry Wayne Edwards practices in Benton Harbor, MI and has the professional credentials of BS. The NPI Number for Larry Wayne Edwards is 1184375016 and holds a License No. (Michigan).

The current practice location address for Larry Wayne Edwards is 1022 E Main St, Benton Harbor, MI and can be reached out via phone at 269-926-0015 and via fax at 269-926-0123.

Location: 1022 E Main St, Benton Harbor, MI, 49022-3036
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184375016
Provider Name
Larry Wayne Edwards
Credential
BS
Provider Entity Type
Individual
Gender
Male
Address
1022 E Main St, Benton Harbor, MI, 49022-3036
Phone Number
269-926-0015
Fax Number
269-926-0123
Provider Enumeration Date
01/12/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1022 E Main St
City
Benton Harbor
State
Michigan
Zip
49022-3036
Phone Number
269-926-0015
Fax Number
269-926-0123
person
Provider Business Mailing Address Details
Address
1022 E Main St
City
Benton Harbor
State
Michigan
Zip
49022-3036
Phone Number
269-926-0015
Fax Number
269-926-0123
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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