Provider Demographics
NPI:1669850343
Name:ENCOURAGE INSTITUTE FOR TEACHING AND LEARNING, LLC
Entity Type:Organization
Organization Name:ENCOURAGE INSTITUTE FOR TEACHING AND LEARNING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROZENDAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ET/P
Authorized Official - Phone:616-530-2224
Mailing Address - Street 1:3260 EAGLE PARK DR NE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-4569
Mailing Address - Country:US
Mailing Address - Phone:616-530-2224
Mailing Address - Fax:616-825-6164
Practice Address - Street 1:3260 EAGLE PARK DR NE
Practice Address - Street 2:SUITE 117
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-4569
Practice Address - Country:US
Practice Address - Phone:616-530-2224
Practice Address - Fax:616-825-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MI6401011380101YP2500X
MI11518391103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty