Provider Demographics
NPI:1174275473
Name:RUTH LEE CENTER FOR HEALING AND GROWTH
Entity Type:Organization
Organization Name:RUTH LEE CENTER FOR HEALING AND GROWTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:STERNAMAN-ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:269-944-7692
Mailing Address - Street 1:13560 76TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-9483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6560 RED ARROW HWY STE C
Practice Address - Street 2:
Practice Address - City:COLOMA
Practice Address - State:MI
Practice Address - Zip Code:49038-8753
Practice Address - Country:US
Practice Address - Phone:269-944-7692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty