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General NPI Number Information
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NPI Number | 1215471669
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Entity Type | Organization
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Legal Business Name | SHS OF NORTHERN MICHIGAN LLC
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Dates
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Enumeration Date | 12/05/2016
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 221 E FELSHAW ST
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City | GAYLORD
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State | MI
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Zip | 49735-1603
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Country | US
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Telephone | 989-448-8323
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Fax |
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Provider Business Mailing Address
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Address Line | 221 E FELSHAW ST
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City | GAYLORD
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State | MI
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Zip | 49735-1603
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Country | US
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Telephone | 989-448-8323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLA L PARKES
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Credential | RN
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Telephone | 989-448-8323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | D4128P
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License Number State | MI
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