Healthcare Provider Details
I. General information
NPI: 1881804581
Provider Name (Legal Business Name): VAN BUREN-CASS COUNTY DISTRICT HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2007
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
260 SOUTH ST
LAWRENCE MI
49064-9325
US
IV. Provider business mailing address
260 SOUTH ST
LAWRENCE MI
49064-9325
US
V. Phone/Fax
- Phone: 269-621-3143
- Fax: 269-621-2725
- Phone: 269-621-3143
- Fax: 269-621-2725
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIELLE
PERSKY
Title or Position: HEALTH OFFICER ADMINISTRATOR
Credential:
Phone: 269-621-3143