Healthcare Provider Details

I. General information

NPI: 1508471574
Provider Name (Legal Business Name): MISSION POINT OF HANCOCK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 POPLAR ST
HANCOCK MI
49930-1121
US

IV. Provider business mailing address

1400 POPLAR ST
HANCOCK MI
49930-1121
US

V. Phone/Fax

Practice location:
  • Phone: 906-482-6644
  • Fax:
Mailing address:
  • Phone: 906-482-6644
  • Fax: 906-482-0983

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: MRS. KRISTINE RANEL KIRK
Title or Position: REGULATORY ANALYST
Credential:
Phone: 417-846-3521