Provider Demographics
NPI:1184452963
Name:TAPESTRY PSYCHIATRIC STAFFING SERVICES LLC
Entity type:Organization
Organization Name:TAPESTRY PSYCHIATRIC STAFFING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:219-929-8385
Mailing Address - Street 1:1861 LOCKMERE DR SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-6319
Mailing Address - Country:US
Mailing Address - Phone:219-929-8385
Mailing Address - Fax:
Practice Address - Street 1:2774 BIRCHCREST DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-5477
Practice Address - Country:US
Practice Address - Phone:616-381-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty