Healthcare Provider Details

I. General information

NPI: 1871508309
Provider Name (Legal Business Name): REGION II COMMISSION ON SERVICES TO THE AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N. MAIN ST.
BROOKLYN MI
49230-0189
US

IV. Provider business mailing address

PO BOX 189
BROOKLYN MI
49230-0189
US

V. Phone/Fax

Practice location:
  • Phone: 517-592-1974
  • Fax: 517-592-1975
Mailing address:
  • Phone: 517-592-1974
  • Fax: 517-592-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE WETHERBY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 517-592-1974