Provider Demographics
NPI:1548083629
Name:BRANCH COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity type:Organization
Organization Name:BRANCH COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILDRENS SERVICES DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GIRON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA/LBA
Authorized Official - Phone:517-278-2129
Mailing Address - Street 1:PINES BEHAVIORAL HEALTH SERVICES
Mailing Address - Street 2:200 VISTA DR
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-9998
Mailing Address - Country:US
Mailing Address - Phone:517-278-2129
Mailing Address - Fax:517-279-8172
Practice Address - Street 1:PINES BEHAVIORAL HEALTH SERVICES
Practice Address - Street 2:200 VISTA DR
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-9998
Practice Address - Country:US
Practice Address - Phone:517-278-2129
Practice Address - Fax:517-279-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty