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General NPI Number Information
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NPI Number | 1033324546
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Entity Type | Organization
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Legal Business Name | ANTRIM COUNTY COMMISSION ON AGING
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10519 W. US 31
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City | WILLIAMSBURG
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State | MI
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Zip | 49690
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Country | US
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Telephone | 231-533-8703
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Fax | 231-533-5310
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Provider Business Mailing Address
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Address Line | PO BOX 614
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City | BELLAIRE
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State | MI
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Zip | 49615-0614
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Country | US
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Telephone | 231-533-8703
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Fax | 231-533-5310
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Authorized Official
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Title or Position | DIRECTOR
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Name | CAROL A. MITCHELL
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Credential | RN, BSN
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Telephone | 231-533-8703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 38-600098
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License Number State | MI
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