Cody Lee Cupp

Individual provider Active NPI Community/Behavioral Health Agency · Lexington, MI

NPI 1174301733 · NPPES record last updated Sep 15, 2023

Key facts

NPI
1174301733
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
7265 Lakeshore Rd
Lexington, MI 48450-9779
Phone
(810) 625-3250
NPI assigned
Sep 15, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

7265 Lakeshore Rd
Lexington, MI 48450-9779

Mailing address

7265 Lakeshore Rd
Lexington, MI 48450-9779
Phone (810) 625-3250

Other providers in Lexington, MI

All providers in Lexington, MI · Community/Behavioral Health Agency in Michigan

Sources for this page

Verify at the official NPI Registry.