Great Lakes Psychiatric Services, P.C.

LBN: Great Lakes Psychiatric Services, P.C.
Great Lakes Psychiatric Services, P.C. is an health care organization with primary practice located at 1179 E Paris Ave Se Suite 220, Grand Rapids MI 49546-8371. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty. Great Lakes Psychiatric Services, P.C. can be contacted via phone (616) 454-2004, or through Vander Velde, David Dirk via phone (616) 454-2004.

Contact Information

Primary practice address
1179 E Paris Ave Se Suite 220 Grand Rapids MI 49546-8371
Fax: (616) 454-0061
Website:
Authorized official contact:
Name: Vander Velde, David Dirk Doctor of Osteopathy (DO)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X 5101009000 Michigan

Profile Details

NPI number 1275653115
LBN Legal business name Great Lakes Psychiatric Services, P.C.
DBA Doing business as
Authorized official Vander Velde, David Dirk Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275653115 NPPES
Michigan Other 26OD111150 BLUE CROSS BLUE SHIELD

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