Healthcare Provider Details

I. General information

NPI: 1699396010
Provider Name (Legal Business Name): RONALD MCDONALD HOUSE OF MID-MICHIGAN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S HOLMES ST
LANSING MI
48912-2052
US

IV. Provider business mailing address

121 S HOLMES ST
LANSING MI
48912-2052
US

V. Phone/Fax

Practice location:
  • Phone: 517-485-9303
  • Fax: 517-485-9810
Mailing address:
  • Phone: 517-485-9303
  • Fax: 517-485-9810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN HURST
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 517-485-9303