Provider Demographics
NPI:1053442095
Name:DOWNRIVER MENTAL HEALTH CLINIC
Entity Type:Organization
Organization Name:DOWNRIVER MENTAL HEALTH CLINIC
Other - Org Name:ADVANCED COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW ACSW BCD
Authorized Official - Phone:248-213-0501
Mailing Address - Street 1:20600 EUREKA RD
Mailing Address - Street 2:SUITE 819
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5343
Mailing Address - Country:US
Mailing Address - Phone:734-285-8282
Mailing Address - Fax:734-281-0402
Practice Address - Street 1:7600 GRAND RIVER RD
Practice Address - Street 2:SUITE 290
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7333
Practice Address - Country:US
Practice Address - Phone:810-220-2787
Practice Address - Fax:810-220-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7509203960OtherBCBS SA