NPIMap

Organization Active NPI

Kalamazoo Community Mental Health and Substance Abuse Services

  • Community/Behavioral Health Agency
  • Kalamazoo, MI
National Provider Identifier
1477815645
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
390177 Issued in MI
Legal business name
KALAMAZOO COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES
Practice address
3299 Gull Rd
W1F4
Kalamazoo, MI 49048
Phone
(269) 553-8000
Fax
(269) 553-8012
NPI assigned
Jun 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward R Sova Jr.
Title
It Director
Phone
(269) 553-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 390177 MI Primary

Addresses

Primary practice location

3299 Gull Rd
W1F4
Kalamazoo, MI 49048

Mailing address

3299 Gull Rd
PO Box63, W1F4
Kalamazoo, MI 49048-1281
Phone (269) 553-8000

Other identifiers 1

IdentifierTypeStateIssuer
390177OtherMISUBSTANCE ABUSE LICENSE#

National Provider Directory

National Provider Directory
Tax ID family
Integrated Services of Kalamazoo5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3299 Gull Rd
#W1F4
Kalamazoo, MI 49048
Phone (269) 553-8000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1477815645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 GULL RD",
            "address_2": "PO BOX63, W1F4",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481281",
            "telephone_number": "269-553-8000",
            "fax_number": "269-553-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 GULL RD",
            "address_2": "W1F4",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49048",
            "telephone_number": "269-553-8000",
            "fax_number": "269-553-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALAMAZOO COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "SOVA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "IT DIRECTOR",
        "authorized_official_telephone_number": "269-553-8000",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "390177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE ABUSE LICENSE#",
            "identifier": "390177",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.