Healthcare Provider Details
I. General information
NPI: 1598097719
Provider Name (Legal Business Name): ST ISABELLAS HOME HEALTH & HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
195 AIRPORT CIRCLE DR
NEGAUNEE MI
49866-9518
US
IV. Provider business mailing address
195 AIRPORT CIRCLE DR
NEGAUNEE MI
49866-9518
US
V. Phone/Fax
- Phone: 906-475-9694
- Fax:
- Phone: 906-475-9694
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ANETTE
FLORA
CHAPERON
Title or Position: ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 906-475-9694