Provider Demographics
NPI:1306050596
Name:ENCOMPASS
Entity type:Organization
Organization Name:ENCOMPASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEOOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:616-459-9180
Mailing Address - Street 1:4829 E. BELTLINE NE
Mailing Address - Street 2:BLDG #1
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525
Mailing Address - Country:US
Mailing Address - Phone:616-459-9180
Mailing Address - Fax:616-459-9181
Practice Address - Street 1:4829 E. BELTLINE NE
Practice Address - Street 2:BLDG #1
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525
Practice Address - Country:US
Practice Address - Phone:800-788-8630
Practice Address - Fax:616-459-9181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801064268104100000X
MI102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty