Provider Demographics
NPI:1972102085
Name:RLD LLC
Entity type:Organization
Organization Name:RLD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUHON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:616-208-5256
Mailing Address - Street 1:2922 FULLER AVE NE STE 116
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-3459
Mailing Address - Country:US
Mailing Address - Phone:616-208-5256
Mailing Address - Fax:616-226-4838
Practice Address - Street 1:2922 FULLER AVE NE STE 116
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-3459
Practice Address - Country:US
Practice Address - Phone:616-208-5256
Practice Address - Fax:616-226-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health