Provider Demographics
NPI:1265527337
Name:ASCENSION BRIGHTON CENTER FOR RECOVERY
Entity type:Organization
Organization Name:ASCENSION BRIGHTON CENTER FOR RECOVERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASST MED DEPT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:JEUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:482-388-4182
Mailing Address - Street 1:12851 GRAND RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8596
Mailing Address - Country:US
Mailing Address - Phone:810-227-1211
Mailing Address - Fax:810-227-1869
Practice Address - Street 1:12851 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8596
Practice Address - Country:US
Practice Address - Phone:810-227-1211
Practice Address - Fax:810-227-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI470001282N00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
100016OtherPREFERRED CHOICE
11-0-D7-1024-0OtherBLUE CROSS
HL 470001OtherM-CARE
P100016OtherCARE CHOICE HEALTH PLAN
049284OtherVALUE OPTIONS
MI20350OtherBLUE CROSS
11-0-D7-1024-0OtherBLUE CARE NETWORK
230279OtherHEALTH ALLIANCE PLAN
100016-56OtherCARE CHOICE
20350OtherBLUE CARE NETWORK/OTHER
9000364OtherHEALTH PLUS
20350OtherBLUE CARE NETWORK/OTHER