NPIMap

Organization Active NPI

Berrien Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Benton Harbor, MI
National Provider Identifier
1760818827
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BERRIEN MENTAL HEALTH AUTHORITY
Doing business as
Riverwood Center
Practice address
1485 M 139
Benton Harbor, MI 49022-5711
Phone
(269) 934-1611
NPI assigned
Sep 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Authorized official

Name
Brett A Lyzenga
Title
Business Office Manager
Phone
(269) 934-1611

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1485 M 139
Benton Harbor, MI 49022-5711

Mailing address

1485 M 139
Benton Harbor, MI 49022-5711
Phone (269) 934-1611

Other identifiers 1

IdentifierTypeStateIssuer
1716175MedicaidMI

Other names 1

  • Riverwood Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Berrien Mental Authority3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538697600000",
    "number": "1760818827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225711",
            "telephone_number": "269-934-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225711",
            "telephone_number": "269-934-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRIEN MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2018-10-05",
        "status": "A",
        "authorized_official_last_name": "LYZENGA",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "269-934-1611"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1716175",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverwood Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.