=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205807989
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MERCY NORTH HOMECARE & HOSPICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2006
-----------------------------------------------------
Last Update Date | 08/05/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7985 MACKINAW TRL SUITE 100
-----------------------------------------------------
City | CADILLAC
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49601-8111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-712-9550
-----------------------------------------------------
Fax | 231-779-9554
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 9185
-----------------------------------------------------
City | FARMINGTON HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48333-9185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-542-8220
-----------------------------------------------------
Fax | 734-542-8286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DON MEIERANT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 231-712-9550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 843511
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------