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Roots 45
Mental Health Clinic/Center (Including Community Mental Health Center) in Gaylord, Michigan
NPI 1235725516

Roots 45 is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Gaylord, MI and is specialized in Mental Health (Including Community Mental Health Center). Roots 45 practices in Gaylord, MI. The NPI Number for Roots 45 is 1235725516 and holds a License No. (Michigan).

The current practice location address for Roots 45 is 100 W 1St St, Gaylord, MI and can be reached out via phone at 989-350-3053.

Location: 100 W 1St St, Gaylord, MI, 49735-6403
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235725516
Provider Name
Roots 45
Credential
Provider Entity Type
Organization
Address
100 W 1St St, Gaylord, MI, 49735-6403
Phone Number
989-350-3053
Fax Number
Provider Enumeration Date
12/21/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6801097139 01 MI MASTER'S SOCIAL WORKER LICENSE
institution
Provider Business Practice Location Address Details
Address
100 W 1St St
City
Gaylord
State
Michigan
Zip
49735-1355
Phone Number
989-350-3053
Fax Number
person
Provider Business Mailing Address Details
Address
100 W 1St St
City
Gaylord
State
Michigan
Zip
49735-1355
Phone Number
989-350-3053
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
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