| Zion Healing Center Of Grand Rapids Llc | |
|
3501 Lake Eastbrook Blvd Se Ste 150 Grand Rapids MI 49546-5940 | |
| (616) 460-1168 | |
| Not Available |
| Full Name | Zion Healing Center Of Grand Rapids Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3501 Lake Eastbrook Blvd Se Ste 150, Grand Rapids, Michigan |
| Authorized Official Name and Position | James Mueller (OWNER) |
| Authorized Official Contact | 6164601168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zion Healing Center Of Grand Rapids Llc 3501 Lake Eastbrook Blvd Se Ste 150 Grand Rapids MI 49546-5940 Ph: (616) 460-1168 | Zion Healing Center Of Grand Rapids Llc 3501 Lake Eastbrook Blvd Se Ste 150 Grand Rapids MI 49546-5940 Ph: (616) 460-1168 |
| NPI Number | 1467282343 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 10/24/2024 |
| Certification Date | 10/24/2024 |
| Medicare PECOS PAC ID | 3476072679 |
|---|---|
| Medicare Enrollment ID | O20250521001058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467282343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kelly M Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992160451 PECOS PAC ID: 5597051656 Enrollment ID: I20160915002190 |
| Provider Name | Allison Meyaard-schapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902457229 PECOS PAC ID: 7719334671 Enrollment ID: I20231114002965 |
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