Provider Demographics
NPI:1770229759
Name:ROSE CENTER FOR HEALING, LLC
Entity Type:Organization
Organization Name:ROSE CENTER FOR HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEED
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:269-286-4355
Mailing Address - Street 1:839 S CEDAR ST STE 150
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-2085
Mailing Address - Country:US
Mailing Address - Phone:269-286-4355
Mailing Address - Fax:
Practice Address - Street 1:839 S CEDAR ST STE 150
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-2085
Practice Address - Country:US
Practice Address - Phone:269-286-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1437689791OtherNPI