Healthcare Provider Details

I. General information

NPI: 1629064332
Provider Name (Legal Business Name): COUNTY OF CASS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23770 HOSPITAL ST
CASSOPOLIS MI
49031-9644
US

IV. Provider business mailing address

23770 HOSPITAL ST
CASSOPOLIS MI
49031-9644
US

V. Phone/Fax

Practice location:
  • Phone: 269-445-3801
  • Fax:
Mailing address:
  • Phone: 269-445-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MERRI TERBORGH
Title or Position: ADMINISTRATOR
Credential:
Phone: 269-445-3801