Healthcare Provider Details

I. General information

NPI: 1659374668
Provider Name (Legal Business Name): ST. JOSEPH HOME HEALTH & HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 GERMAN ST
TAWAS CITY MI
48763-9349
US

IV. Provider business mailing address

PO BOX 239
TAWAS CITY MI
48764-0239
US

V. Phone/Fax

Practice location:
  • Phone: 989-362-4611
  • Fax: 989-362-8771
Mailing address:
  • Phone: 989-362-4611
  • Fax: 989-362-8771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: ANN M BALFOUR
Title or Position: ADMINISTRATOR
Credential:
Phone: 989-362-4611