Russom Recovery Therapies LLC

NPI #1073154837 in Grand Rapids, Michigan

Provider Information

NPI Number: 1073154837
Entity Type: Organization
Organization Name: Russom Recovery Therapies LLC
Primary Specialty: Social Worker
Enumeration Date: Oct 3, 2019
Last Updated: Mar 26, 2025

Practice Location

Address: 4519 CASCADE RD SE STE 5
City: Grand Rapids
State: Michigan
ZIP Code: 49546-8319
Phone: (616) 228-2045

Authorized Official

Name: MARY BETH HOUPT
Title: CREDENTIALING
Phone: (517) 676-9797

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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