Cj12 Corporation

NPI #1649915885 in Grand Ledge, Michigan

Provider Information

NPI Number: 1649915885
Entity Type: Organization
Organization Name: Cj12 Corporation
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: May 2, 2022
Last Updated: May 2, 2022

Practice Location

Address: 11907 STONE BLUFF DR
City: Grand Ledge
State: Michigan
ZIP Code: 48837-2435
Phone: (517) 242-8895

Authorized Official

Name: HEATHER LYNN TERHAAR
Title: CHIEF EXECUTIVE OFFICER
Phone: (517) 242-8895

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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