Provider Demographics
NPI:1174056725
Name:UNITED RESOLUTION SERVICES
Entity type:Organization
Organization Name:UNITED RESOLUTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHM
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:517-215-4243
Mailing Address - Street 1:9883 SAND LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:ONSTED
Mailing Address - State:MI
Mailing Address - Zip Code:49265-9546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9883 SAND LAKE HWY
Practice Address - Street 2:
Practice Address - City:ONSTED
Practice Address - State:MI
Practice Address - Zip Code:49265-9546
Practice Address - Country:US
Practice Address - Phone:517-215-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801099246251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801099246OtherMICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS (LARA)