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23D2095713 CLIA NUMBER - MONTCALM CENTER FOR BEHAVIORAL HEALTH

Laboratory Demographics

CLIA Number: 23D2095713

Facility Name: MONTCALM CENTER FOR BEHAVIORAL HEALTH

Facility Address:
611 N STATE STREET
STANTON, MI
ZIP 48888
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Facility Phone Number: 989 831-7527

Facility Type: Practitioner Other

Certificate Type: Waiver
NPI Number: 1326077330

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 23D2095713
LAB Type Practitioner Other
Facility Name MONTCALM CENTER FOR BEHAVIORAL HEALTH
Street 611 N STATE STREET
City STANTON
State MI
ZIP 48888
Phone 989 831-7527
CertificateType 4
CertificateEffectiveDate 5/11/2023
CertificateExpirationDate 5/10/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024