NPI | 1386926004 |
---|---|
Doing Business As | SOUTHSIDE HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | TASHA BLACKMON CEO 616-965-8215 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
103TC0700X Psychologist, Clinical | |
1041C0700X Social Worker, Clinical | |
163W00000X Registered Nurse | |
207LA0401X Anesthesiology, Addiction Medicine | |
Enumeration Date | 2011-09-20 |
Last Update Date | 2023-08-25 |