Provider Demographics
NPI:1225354293
Name:DISABILITY CONNECTION
Entity Type:Organization
Organization Name:DISABILITY CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUTIER-MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-722-0088
Mailing Address - Street 1:1871 PECK ST
Mailing Address - Street 2:MUSKEGON
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-2534
Mailing Address - Country:US
Mailing Address - Phone:231-722-0088
Mailing Address - Fax:231-722-0066
Practice Address - Street 1:1871 PECK ST
Practice Address - Street 2:MUSKEGON
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2534
Practice Address - Country:US
Practice Address - Phone:231-722-0088
Practice Address - Fax:231-722-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health