Clyde A Richardson in Grand Rapids - Addiction (substance Use Disorder)
Clyde A Richardson - NPI 1275709826
Clyde A Richardson is a Addiction (substance Use Disorder) in Grand Rapids, Michigan. Clyde A Richardson practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Clyde A Richardson is 1275709826. The last update date is 2009-06-26.
Clyde A Richardson's current location address is 3210 Eagle Run Dr, Grand Rapids, Michigan. You can contact this provider via phone number 6169571200 and fax number 6169571297. The mailing address for Clyde A Richardson is 3210 Eagle Run Dr, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
Provider Name | Clyde A Richardson |
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Address | 3210 Eagle Run Dr, Grand Rapids, Michigan |
Phone Number | 6169571200 |
Fax Number | 6169571297 |
Sole Proprietor | N |
Credentials | M DIV CAC- |
NPI Number Detail
NPI Number | 1275709826 |
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Provider Enumeration Date | 2008-05-05 |
Last Updated Date | 2009-06-26 |
Provider Mailing Address Detail
Address | 3210 Eagle Run Dr |
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City | Grand Rapids |
State | Michigan (MI) |
Post Code | 49525 |
Phone Number | 6169571200 |
Fax Number | 6169571297 |
Provider's Primary Taxonomy Detail
Speciality | Addiction (substance Use Disorder) |
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Taxonomy | 101Ya0400X |
Licence No | 6802067415 |
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
NONE | NONE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Clyde A Richardson by the Centers for Medicare & Medicaid Services?
The Clyde A Richardson has been issued the NPI (National Provider Identifier) 1275709826, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Clyde A Richardson is physically located?
The Clyde A Richardson is physically situated at the following address: 3210 Eagle Run Dr, Grand Rapids, MI, 49525.
What is the Clyde A Richardson's area of specialization and corresponding taxonomy classification?
The Clyde A Richardson's specialty field is Addiction (substance Use Disorder), and it falls under the taxonomy code 101Ya0400X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1275709826 to Clyde A Richardson?
The Centers for Medicare & Medicaid Services assigned the 1275709826 to Clyde A Richardson on 2008-05-05.
When was the information related to Clyde A Richardson most recently updated or refreshed?
The details pertaining to the Clyde A Richardson, including its address, specialty, and other relevant information, were last updated or refreshed on 2009-06-26.
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