Healthcare Provider Details

I. General information

NPI: 1104917079
Provider Name (Legal Business Name): MCLAREN LAPEER REGION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 N MAIN ST
LAPEER MI
48446-1350
US

IV. Provider business mailing address

1375 N MAIN ST
LAPEER MI
48446-1350
US

V. Phone/Fax

Practice location:
  • Phone: 810-667-5500
  • Fax: 810-342-1335
Mailing address:
  • Phone: 810-667-5500
  • Fax: 810-342-1335

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: FRED KORTE
Title or Position: VP/CFO
Credential:
Phone: 810-342-2000