Healthcare Provider Details

I. General information

NPI: 1861996464
Provider Name (Legal Business Name): COUNTY OF BARRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 NASHVILLE RD
HASTINGS MI
49058-8824
US

IV. Provider business mailing address

2700 NASHVILLE RD
HASTINGS MI
49058-8824
US

V. Phone/Fax

Practice location:
  • Phone: 269-945-2407
  • Fax: 269-945-5380
Mailing address:
  • Phone: 269-945-2407
  • Fax: 269-945-5380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA K DEHAAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 269-945-2407