Healthcare Provider Details

I. General information

NPI: 1629618301
Provider Name (Legal Business Name): ADRIAN DOMINICAN SISTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 E SIENA HEIGHTS DR
ADRIAN MI
49221-1793
US

IV. Provider business mailing address

PO BOX 489
ADRIAN MI
49221-0489
US

V. Phone/Fax

Practice location:
  • Phone: 517-266-3556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARILYN KAY LENHART
Title or Position: FINANCE OFFICE MANAGER
Credential: DO
Phone: 517-266-3556