Provider Demographics
NPI:1255386124
Name:MID-MICHIGAN RECOVERY SERVICES, INC.
Entity type:Organization
Organization Name:MID-MICHIGAN RECOVERY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-887-0226
Mailing Address - Street 1:913 W HOLMES RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-0426
Mailing Address - Country:US
Mailing Address - Phone:517-887-0226
Mailing Address - Fax:517-887-8121
Practice Address - Street 1:913 W HOLMES RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-0426
Practice Address - Country:US
Practice Address - Phone:517-887-0226
Practice Address - Fax:517-887-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI330011324500000X
MI330021324500000X
MI330001261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility