WEDGWOOD CHRISTIAN SERVICES (NPI# 1215047667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215047667 |
| Entity Type | Organization |
| Organization Name | WEDGWOOD CHRISTIAN SERVICES |
| Other Organization Name | WEDGWOOD CHRISTIAN SERVICES |
| Practice Address |
3300 36th St Se Grand Rapids MI 49512-2810 |
| Practice Telephone | 6169422110 |
| Practice Fax Number | 6169420589 |
| Mailing Telephone | 6169422110 |
| Mailing Fax Number | 6169420589 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2014-10-21 |
| Authorized Official Name | MRS. JUNE BUFKIN (DIRECTOR OF QUALITY SERVICES) |
| Authorized Official Telephone | 6168315590 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1464983 | 05 |
| Other Name | Type Code |
|---|---|
| Wedgwood Christian Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730302308 | Wedgwood Christian Services | Case Management | 3351 36th St Se, Grand Rapids, MI 49512-2809 | 2007-04-11 |
| 1154505337 | Wedgwood Christian Services | Community/Behavioral Health | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2007-12-24 |
| 1235252750 | Wedgwood Christian Services | Counselor | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2007-04-09 |
| 1972635761 | Wedgwood Christian Services | Counselor | 2520 Eastern Ave Se, Grand Rapids, MI 49507-3633 | 2007-03-09 |
| 1326122516 | Wedgwood Christian Services | Counselor | 3180 Racquet Club Dr, Ste. G, Traverse City, MI 49684-4797 | 2006-10-24 |
| 1902997224 | Wedgwood Christian Services | Clinic/Center | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2006-09-28 |
| Street Address |
3300 36TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49512-2810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345005 | Khrystal Lewis | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-10-30 |
| 1528675105 | Aleah Caizza | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-28 |
| 1356958144 | Joyce Marie Mason | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-25 |
| 1689280638 | Aaron Jeremy Ackley | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-16 |
| 1588270417 | Hayley Landstra | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-16 |
| 1972114288 | Ashley Pecott | Counselor | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-11 |
| 1376154856 | Zorica Baka | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-10 |
| 1588274336 | Jenna Beson | Student in an Organized Health Care Education/Training Program | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-06 |
| 1821608795 | Evan Helene Pellow-robbins | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-05 |
| 1871101105 | Kierra Thomas | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1013493733 | Pharmascript of Michigan Gr LLC | Pharmacy | 2661 29th St. Se Suite A, Grand Rapids, MI 49512 | 2018-07-16 |
| 1245736040 | Cassandra Slater | Technician, Other | 2925 Breton Rd Se, Grand Rapids, MI 49512 | 2018-04-02 |
| 1235632704 | John Mitchell Tanja | Occupational Therapist | 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 | 2018-03-12 |
| 1952829855 | Sarah Harlow | Physical Therapist | 2951 44th St Se, Kentwood, MI 49512 | 2017-08-31 |
| 1194248815 | Melinda Huizenga | Registered Nurse | 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 | 2017-07-25 |
| 1659812931 | Frantzie Pierre | Counselor | 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 | 2017-03-20 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1518282631 | Melanie Anne Hogeterp | Social Worker | 3180 East Paris Se, Kentwood, MI 49512 | 2010-03-31 |
| 1013147495 | Ardean Beth Brock-vanderwall | Counselor | 2828 Kraft Ave., Grand Rapids, MI 49512 | 2009-07-20 |
| Find all providers in zip 49512 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, 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. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1013487990 | Compass Behavioral Health LLC | Community/Behavioral Health | 2214 Norway St, Grand Rapids, MN 55744-9654 | 2018-12-04 |
| 1972041721 | Community Recovery Counseling Center, Pllc | Community/Behavioral Health | 1975 Jefferson Ave Se, Grand Rapids, MI 49507-2511 | 2017-02-01 |
| 1275079923 | Kool Counseling, LLC | Community/Behavioral Health | 2335 Burton St Se, Suite 130, Grand Rapids, MI 49506-4669 | 2017-01-18 |
| 1700253895 | Living Well Recreation Therapy | Community/Behavioral Health | 1351 Sherman St Se, Grand Rapids, MI 49506-2613 | 2015-08-25 |
| 1699157677 | First Call for Help of Itasca County | Community/Behavioral Health | 1007 Nw 4th St, Grand Rapids, MN 55744-2203 | 2015-06-25 |
| 1417355322 | Melita Travis Johnson, Lmsw, Ccdp | Community/Behavioral Health | 770 Kenmoor Ave Se Ste 103, Grand Rapids, MI 49546-8602 | 2014-12-09 |
| 1093134926 | J Hill Psychological Services L.l.c | Community/Behavioral Health | 201 Nw 4th St Ste 7, Grand Rapids, MN 55744-2753 | 2014-04-08 |
| 1457774242 | The Asian Center | Community/Behavioral Health | 4040 Fulton St E, Grand Rapids, MI 49546-1352 | 2014-01-29 |
| 1083059141 | Joyce Lenise Williams | Community/Behavioral Health | 1440 Fuller Ave Se, Grand Rapids, MI 49507-2191 | 2013-05-02 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49512 |
Please comment or provide details below to improve the information on WEDGWOOD CHRISTIAN SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.