Provider Demographics
NPI:1427924398
Name:ALPENGLOW MENTAL HEALTH
Entity type:Organization
Organization Name:ALPENGLOW MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBERTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-222-2109
Mailing Address - Street 1:7950 MOORSBRIDGE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-4420
Mailing Address - Country:US
Mailing Address - Phone:269-222-2109
Mailing Address - Fax:800-350-5021
Practice Address - Street 1:7950 MOORSBRIDGE RD STE 305
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4420
Practice Address - Country:US
Practice Address - Phone:269-222-2109
Practice Address - Fax:800-350-5021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty