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NPI 1013294628

OrganizationActive

139 Education, LLC.

NPI 1013294628 · Psychologist · Grandville, MI

Provider details

NPI number: 1013294628
Entity type: Organization
Primary specialty: PsychologistBehavioral Health & Social Service Providers
Authorized official: Timothy Royer, Provider/Authorized Official
License: 6301009353 (MI)

Practice location

3148 44th St Sw

Grandville, MI 49418

Phone: (800) 600-4096

Fax: (800) 606-8839

More MI providers

Mailing address

201 Monroe Ave Nw

Grand Rapids, MI 49503

Registry dates

Enumerated: 2011-11-10
Last updated: 2017-02-21

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

139 Education, LLC. — NPI 1013294628, Grandville, MI | NPI Central