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Great Lakes Psychiatric Services, P.c.
Adult Mental Health Clinic/Center in Grand Rapids, Michigan
NPI 1275653115

Great Lakes Psychiatric Services, P.c. is an Adult Mental Health Clinic/Center based in Grand Rapids, MI and is specialized in Adult Mental Health. Great Lakes Psychiatric Services, P.c. practices in Grand Rapids, MI. The NPI Number for Great Lakes Psychiatric Services, P.c. is 1275653115 and holds a License No. 5101009000 (Michigan).

The current practice location address for Great Lakes Psychiatric Services, P.c. is 1179 E Paris Ave Se, Grand Rapids, MI and can be reached out via phone at 616-454-2004 and via fax at 616-454-0061.

Location: 1179 E Paris Ave Se, Grand Rapids, MI, 49546-8371
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1275653115
Provider Name
Great Lakes Psychiatric Services, P.c.
Credential
Provider Entity Type
Organization
Address
1179 E Paris Ave Se, Grand Rapids, MI, 49546-8371
Phone Number
616-454-2004
Fax Number
616-454-0061
Provider Enumeration Date
03/31/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
26OD111150 01 MI BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1179 E Paris Ave Se
City
Grand Rapids
State
Michigan
Zip
49546-8371
Phone Number
616-454-2004
Fax Number
616-454-0061
person
Provider Business Mailing Address Details
Address
1179 E Paris Ave Se
City
Grand Rapids
State
Michigan
Zip
49546-8371
Phone Number
616-454-2004
Fax Number
616-454-0061
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
5101009000 (Michigan)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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