MARK F. PETERSON, I – NPI #1841474012
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
MARK PETERSON, I is a community based residential treatment facility located in GRAND RAPIDS, MI. NPPES has assigned the NPI number 1841474012 to MARK PETERSON, I on December 24, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.
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NPI Profile for
MARK F. PETERSON, I
(more than 18 years ago)
GRAND RAPIDS, MI 49331 Phone: (616) 831-5659 Fax:
GRAND RAPIDS, MI 49546 Phone: (616) 831-5659 Fax:
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary) |
MI | 6802071051 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.