Healthcare Provider Details

I. General information

NPI: 1124025440
Provider Name (Legal Business Name): EMMET COUNTY MEDICAL CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E MAIN ST
HARBOR SPRINGS MI
49740-1548
US

IV. Provider business mailing address

750 E MAIN ST
HARBOR SPRINGS MI
49740-1548
US

V. Phone/Fax

Practice location:
  • Phone: 231-526-4403
  • Fax: 231-526-5252
Mailing address:
  • Phone: 231-526-4403
  • Fax: 231-526-5252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number248510
License Number StateMI

VIII. Authorized Official

Name: MRS. DIANA BAILEY
Title or Position: ADMINSITRATOR
Credential:
Phone: 231-526-4400