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Mr. Edward A Booker JR.
Substance Abuse Rehabilitation Facility in Grand Rapids, Michigan
NPI 1588918841

Edward A Booker JR. is a Substance Abuse Rehabilitation Facility based in Holland, MI. Edward A Booker JR. practices in Grand Rapids, MI. The NPI Number for Edward A Booker JR. is 1588918841 and holds a License No. 410376 (Michigan).

The current practice location address for Edward A Booker JR. is 1740 Willard Ave Se, Grand Rapids, MI and can be reached out via phone at 616-886-6917.

Location: 1740 Willard Ave Se, Grand Rapids, MI, 49424-8246
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588918841
Provider Name
Edward A Booker JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1740 Willard Ave Se, Grand Rapids, MI, 49424-8246
Phone Number
616-886-6917
Fax Number
Provider Enumeration Date
11/07/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1740 Willard Ave Se
City
Grand Rapids
State
Michigan
Zip
49507-2662
Phone Number
616-886-6917
Fax Number
person
Provider Business Mailing Address Details
Address
1740 Willard Ave Se
City
Grand Rapids
State
Michigan
Zip
49507-2662
Phone Number
616-886-6917
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
410376 (Michigan)
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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