| Starfish Center, Inc | |
|
38 S Ridge St # 306 Port Sanilac MI 48469-9789 | |
| (810) 622-0630 | |
| (810) 622-0631 |
| Full Name | Starfish Center, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 38 S Ridge St # 306, Port Sanilac, Michigan |
| Authorized Official Name and Position | Kathleen Marie Gutowski (CLINCIAL PSYCHOLGIST/CEO) |
| Authorized Official Contact | 8106220630 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Starfish Center, Inc 38 S Ridge St # 306 Port Sanilac MI 48469-9789 Ph: (810) 622-0630 | Starfish Center, Inc 38 S Ridge St # 306 Port Sanilac MI 48469-9789 Ph: (810) 622-0630 |
| NPI Number | 1265745590 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 01/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265745590 | NPI | - | NPPES |
| PENDING | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6801087602 (Michigan) | Primary |
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