Provider Demographics
NPI:1205073913
Name:BC PRICE PROFESSIONAL SERVICES LLC
Entity type:Organization
Organization Name:BC PRICE PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:616-540-7089
Mailing Address - Street 1:2422 ABBINGTON DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-5402
Mailing Address - Country:US
Mailing Address - Phone:616-540-7089
Mailing Address - Fax:
Practice Address - Street 1:230 MICHIGAN ST NE
Practice Address - Street 2:STE# 102
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2550
Practice Address - Country:US
Practice Address - Phone:616-540-7089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010659901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty