IndividualActive
Edward Booker
NPI 1588918841 · Substance Abuse Rehabilitation Facility · Grand Rapids, MI
Provider details
- NPI number
- 1588918841
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- 410376 (MI)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1740 Willard Ave Se
Grand Rapids, MI 49507-2662
Phone: (616) 886-6917
Approximate (ZIP-level) locationGet directions
Mailing address
2646 Juniper Ave
Holland, MI 49424-8246
Registry dates
- Enumerated
- 2012-11-07
- Last updated
- 2012-11-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.