Healthcare Provider Details

I. General information

NPI: 1225276223
Provider Name (Legal Business Name): SANE/SART SERVICES OF LAPEER COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 01/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 IMLAY CITY RD
LAPEER MI
48446-3208
US

IV. Provider business mailing address

255 CLAY ST PROSECUTORS OFFICE
LAPEER MI
48446-2205
US

V. Phone/Fax

Practice location:
  • Phone: 810-834-2209
  • Fax: 810-667-0340
Mailing address:
  • Phone: 810-667-0326
  • Fax: 810-667-0340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTINE J SPEER
Title or Position: PROGRAM DIRECTOR
Credential: PHD, RN, SANE-A
Phone: 810-834-2209