Healthcare Provider Details

I. General information

NPI: 1144901380
Provider Name (Legal Business Name): AUNT LISAS DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 SABLE ST
ALPENA MI
49707-1748
US

IV. Provider business mailing address

822 SABLE ST
ALPENA MI
49707-1748
US

V. Phone/Fax

Practice location:
  • Phone: 989-255-6121
  • Fax: 989-340-0605
Mailing address:
  • Phone: 989-255-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LISA JANE MACARTHUR
Title or Position: CEO/OWNER
Credential:
Phone: 989-255-6121