Provider Demographics
NPI:1073769337
Name:ARBOR CIRCLE CORPORATION
Entity Type:Organization
Organization Name:ARBOR CIRCLE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:CHERYL
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW ACSW
Authorized Official - Phone:616-249-8542
Mailing Address - Street 1:3501 LAKE EASTBROOK BLVD SE STE 110
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5966
Mailing Address - Country:US
Mailing Address - Phone:616-249-8542
Mailing Address - Fax:616-726-2463
Practice Address - Street 1:1101 BALL SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506
Practice Address - Country:US
Practice Address - Phone:616-249-8542
Practice Address - Fax:616-726-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801079470251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health