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KENT COUNTY CMH AUTHORITY NPI 1134212442


NPI Information

NPI: 1134212442
Provider Name: KENT COUNTY CMH AUTHORITY

Doing Business As: NETWORK180

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 23D2125494

Address:
790 FULLER AVE NE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 336-3909
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KENT COUNTY CMH AUTHORITY is a community behavioral health in Grand Rapids, MI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. KENT COUNTY CMH AUTHORITY NPI is 1134212442. The provider is registered as an organization entity type.
The provider Is Doing Business As Network180.

The provider's business location address is:

790 FULLER AVE NE
GRAND RAPIDS, MI
ZIP 49503-918
Phone: (616) 336-3909
Fax: (616) 336-8830

The provider's authorized official is William Joseph Ward .
The authorized official title is Executive Director and has the following contact phone number (616) 855-5201.

The CLIA number assigned to this NPI record is 23D2125494 - other - comm mental health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 10/4/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14483602MEDICAIDMICHIGAN
24483611MEDICAIDMARYLAND
34483587MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.