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General NPI Number Information
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NPI Number | 1215934534
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Entity Type | Organization
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Legal Business Name | TUSCOLA COUNTY MEDICAL CARE FACILITY
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 1285 CLEAVER RD
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City | CARO
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State | MI
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Zip | 48723-9241
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Country | US
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Telephone | 989-673-4117
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Fax | 989-673-6665
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Provider Business Mailing Address
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Address Line | 1285 CLEAVER RD
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City | CARO
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State | MI
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Zip | 48723-9241
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Country | US
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Telephone | 989-673-4117
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Fax | 989-673-6665
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARGOT D ROEDEL
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Credential | R.N., N.H.A.
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Telephone | 989-673-4117
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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 | 798510
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License Number State | MI
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