Provider Demographics
NPI:1467823054
Name:PREFERRED EMPLOYMENT & LIVING SUPPORTS
Entity Type:Organization
Organization Name:PREFERRED EMPLOYMENT & LIVING SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BETLEJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-747-8650
Mailing Address - Street 1:1205 PECK ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-2121
Mailing Address - Country:US
Mailing Address - Phone:231-747-8650
Mailing Address - Fax:231-395-5915
Practice Address - Street 1:1205 PECK ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2121
Practice Address - Country:US
Practice Address - Phone:231-747-8650
Practice Address - Fax:231-395-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health