Organization Active NPI

Southeastern Dispute Resolutions Services

  • Community/Behavioral Health Agency
  • Jackson, MI
National Provider Identifier
1851074546
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHEASTERN DISPUTE RESOLUTIONS SERVICES
Practice address
211 W Ganson St Ste 105
Jackson, MI 49201-1262
Phone
(517) 990-0279
NPI assigned
Aug 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Marc Stanley, JD., MPP
Title
Executive Director
Phone
(517) 990-0279

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

211 W Ganson St Ste 105
Jackson, MI 49201-1262

Mailing address

211 W Ganson St Ste 105
Jackson, MI 49201-1262
Phone (517) 990-0279

National Provider Directory

National Provider Directory

Locations

211 W Ganson St
Ste 105
Jackson, MI 49201
Phone (517) 990-0279

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1851074546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W GANSON ST STE 105",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011262",
            "telephone_number": "517-990-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W GANSON ST STE 105",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011262",
            "telephone_number": "517-990-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN DISPUTE RESOLUTIONS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "517-990-0279",
        "authorized_official_credential": "JD., MPP"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.