Elizabeth Upjohn Community Healing Center

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

ELIZABETH UPJOHN COMMUNITY HEALING CENTER

Practice address

1603 Redstock Ave
Portage, MI 49024-4143

Phone

(269) 779-9619

NPI assigned

Jan 24, 2017

Organization subpart

No

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

Authorized official

Name

Alison Ciesa, LLMSW

Title

Early Childhood Specialist

Phone

(269) 271-0229

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1750828141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 REDSTOCK AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244143",
            "telephone_number": "269-779-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 REDSTOCK AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244143",
            "telephone_number": "269-779-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH UPJOHN COMMUNITY HEALING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "CIESA",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "EARLY CHILDHOOD SPECIALIST",
        "authorized_official_telephone_number": "269-271-0229",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Portage, MI
• Providers in Portage, MI by specialty
• Early Intervention Provider Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.