Healthcare Provider Details

I. General information

NPI: 1649646696
Provider Name (Legal Business Name): FRIENDS WHO CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 RIVER ST STE B
MANISTEE MI
49660-2742
US

IV. Provider business mailing address

318 RIVER ST STE B
MANISTEE MI
49660-2742
US

V. Phone/Fax

Practice location:
  • Phone: 231-723-4181
  • Fax: 231-723-7780
Mailing address:
  • Phone: 231-723-4181
  • Fax: 231-723-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LESLIE HAHN EZDEBSKI
Title or Position: FIELD NURSE RN
Credential: RN
Phone: 231-843-7959