Provider Demographics
NPI:1750025805
Name:MICHELE MARIE RUTSEY
Entity type:Organization
Organization Name:MICHELE MARIE RUTSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUTSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-827-4383
Mailing Address - Street 1:7751 FARLEY RD
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9155
Mailing Address - Country:US
Mailing Address - Phone:734-827-4383
Mailing Address - Fax:
Practice Address - Street 1:7751 FARLEY RD
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-9155
Practice Address - Country:US
Practice Address - Phone:734-827-4383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)