Provider Demographics
NPI:1467282343
Name:ZION HEALING CENTER OF GRAND RAPIDS LLC
Entity type:Organization
Organization Name:ZION HEALING CENTER OF GRAND RAPIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-460-1168
Mailing Address - Street 1:3501 LAKE EASTBROOK BLVD SE STE 150
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5940
Mailing Address - Country:US
Mailing Address - Phone:616-460-1168
Mailing Address - Fax:
Practice Address - Street 1:3501 LAKE EASTBROOK BLVD SE STE 150
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5940
Practice Address - Country:US
Practice Address - Phone:616-460-1168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty