Healthcare Provider Details

I. General information

NPI: 1841262821
Provider Name (Legal Business Name): NORTHERN HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N CHARLES ST
WHITE CLOUD MI
49349-8600
US

IV. Provider business mailing address

230 N CHARLES ST PO BOX 462
WHITE CLOUD MI
49349-8600
US

V. Phone/Fax

Practice location:
  • Phone: 231-689-0096
  • Fax: 231-689-0044
Mailing address:
  • Phone: 231-689-0096
  • Fax: 231-689-0044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number385555
License Number StateMI

VIII. Authorized Official

Name: MRS. KATHLEEN C AUSTIN
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 231-689-0096