| Reclaim Life Therapy Pllc | |
|
800 Monroe Ave Nw Ste 300 Grand Rapids MI 49503-1445 | |
| (616) 309-0107 | |
| (616) 825-6185 |
| Full Name | Reclaim Life Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 800 Monroe Ave Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Cheryl L Dudgeon (THERAPIST/OWNER) |
| Authorized Official Contact | 6163090107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reclaim Life Therapy Pllc 800 Monroe Ave Nw Ste 300 Grand Rapids MI 49503-1445 Ph: (616) 309-0107 | Reclaim Life Therapy Pllc 800 Monroe Ave Nw Ste 300 Grand Rapids MI 49503-1445 Ph: (616) 309-0107 |
| NPI Number | 1003282724 |
|---|---|
| Provider Enumeration Date | 08/17/2015 |
| Last Update Date | 12/04/2016 |
| Medicare PECOS PAC ID | 6305152919 |
|---|---|
| Medicare Enrollment ID | O20150827001488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003282724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801092199 (Michigan) | Primary |
| Provider Name | Cheryl Lynn Dudgeon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235521063 PECOS PAC ID: 7214243831 Enrollment ID: I20150827001955 |
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