Healthcare Provider Details

I. General information

NPI: 1972532711
Provider Name (Legal Business Name): SANILAC COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 DAWSON ST
SANDUSKY MI
48471-1062
US

IV. Provider business mailing address

171 DAWSON ST
SANDUSKY MI
48471-1062
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-4098
  • Fax: 810-648-2646
Mailing address:
  • Phone: 810-648-4098
  • Fax: 810-648-2646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: DIANNA L. SCHAFER
Title or Position: HEALTH OFFICER
Credential:
Phone: 810-648-4098