WEST MICHIGAN ADDICTION CONSULTANTS, PC (NPI# 1003053133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003053133 |
| Entity Type | Organization |
| Organization Name | WEST MICHIGAN ADDICTION CONSULTANTS, PC |
| Practice Address |
3001 Fuller Ave Ne Suite 1 Grand Rapids MI 49505-3204 |
| Practice Telephone | 6163658800 |
| Practice Fax Number | 6163657979 |
| Mailing Telephone | 6163658800 |
| Mailing Fax Number | 6163657979 |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2009-01-12 |
| Authorized Official Name | DR. THOMAS LAMOTT HAYNES (PRESIDENT) |
| Authorized Official Telephone | 6163658800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 410128 | MI | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588821433 | West Michigan Addiction Consultants, PC | Internal Medicine | 3001 Fuller Ave Ne, Suite 1, Grand Rapids, MI 49505-3247 | 2008-05-19 |
| Street Address |
3001 FULLER AVE NE SUITE 1 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505-3204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588821433 | West Michigan Addiction Consultants, PC | Internal Medicine | 3001 Fuller Ave Ne, Suite 1, Grand Rapids, MI 49505-3247 | 2008-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235789074 | Green Castle Recovery Centers, LLC. | Substance Abuse Rehabilitation Facility | 233 Fulton St E Ste 101, Grand Rapids, MI 49503-3262 | 2019-09-13 |
| 1588918841 | Edward A Booker Jr. | Substance Abuse Rehabilitation Facility | 1740 Willard Ave Se, Grand Rapids, MI 49507-2662 | 2012-11-07 |
| 1609129782 | Ronald Debose | Substance Abuse Rehabilitation Facility | 1139 Thomas St Se, Grand Rapids, MI 49506-2665 | 2012-10-26 |
| 1427115336 | Our Hope Association | Substance Abuse Rehabilitation Facility | 324 Lyon St Ne, Grand Rapids, MI 49503-5607 | 2007-01-02 |
| 1104986603 | Project Rehab | Substance Abuse Rehabilitation Facility | 200 Eastern Ave Se, Grand Rapids, MI 49503-4735 | 2006-12-12 |
| 1962509364 | Hope House of Itasca County, Inc. | Substance Abuse Rehabilitation Facility | 604 S Pokegama Ave, Grand Rapids, MN 55744-3831 | 2006-09-20 |
| 1851496368 | Hope House of Itasca County, Inc. | Substance Abuse Rehabilitation Facility | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2006-09-13 |
| 1891259339 | Hope Network Recovery | Substance Abuse Rehabilitation Facility | 3210 Eagle Run Dr Ne, Grand Rapids, MI 49525-7051 | 2019-01-29 |
| 1841791357 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 300 68th Street Se, Grand Rapids, MI 49548 | 2018-02-21 |
| 1467844258 | Green Castle Recovery Centers, LLC. | Substance Abuse Rehabilitation Facility | 540 Cherry St Se, Grand Rapids, MI 49503-4748 | 2015-03-03 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
Please comment or provide details below to improve the information on WEST MICHIGAN ADDICTION CONSULTANTS, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.