Healthcare Provider Details

I. General information

NPI: 1730186891
Provider Name (Legal Business Name): PINECREST MEDICAL CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N15995 MAIN ST
POWERS MI
49874-9608
US

IV. Provider business mailing address

PO BOX 603
POWERS MI
49874-0603
US

V. Phone/Fax

Practice location:
  • Phone: 906-497-5244
  • Fax: 906-497-5005
Mailing address:
  • Phone: 906-497-5244
  • Fax: 906-497-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number558510
License Number StateMI

VIII. Authorized Official

Name: DANA SMITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 906-497-5641