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General NPI Number Information
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NPI Number | 1083607139
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Entity Type | Organization
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Legal Business Name | HOUGHTON COUNTY MEDICAL CARE FACILITY
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 1100 W QUINCY ST
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City | HANCOCK
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State | MI
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Zip | 49930-1404
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Country | US
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Telephone | 906-482-5050
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Fax | 906-482-4609
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Provider Business Mailing Address
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Address Line | 1100 W QUINCY ST
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City | HANCOCK
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State | MI
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Zip | 49930-1404
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Country | US
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Telephone | 906-482-5050
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Fax | 906-482-4609
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Authorized Official
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Title or Position | SENIOR BILLING SPECIALIST
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Name | MS. DENISE M BRISEBOIS
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Credential | SENIOR BILLING SPECI
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Telephone | 906-483-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 318510
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License Number State | MI
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