Great Lakes Behavioral Health Plc
NPI #1609268754 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1609268754
- Entity Type
- Organization
- Organization Name
- Great Lakes Behavioral Health Plc
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Feb 26, 2015
- Last Updated
- Jun 2, 2015
Practice Location
- Address
- 678 FRONT AVE NW
- Address 2
- SUITE 365
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49504-5325
- Phone
- (616) 920-1816
Authorized Official
- Name
- DAVID VANDER VELDE, DO
- Title
- OWNER
- Phone
- (616) 920-1816
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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