Healthcare Provider Details

I. General information

NPI: 1689796930
Provider Name (Legal Business Name): CHIPPEWA COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 MARQUETTE AVE ROOM 622
SAULT SAINTE MARIE MI
49783-3301
US

IV. Provider business mailing address

508 ASHMUN ST STE 120
SAULT SAINTE MARIE MI
49783-1976
US

V. Phone/Fax

Practice location:
  • Phone: 906-632-5690
  • Fax: 906-635-1325
Mailing address:
  • Phone: 906-635-1568
  • Fax: 906-253-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number6301008585
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number4301030101
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number4301030101
License Number StateMI

VIII. Authorized Official

Name: KAREN MARIE SENKUS
Title or Position: HEALTH OFFICER
Credential:
Phone: 906-253-3103