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General NPI Number Information
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NPI Number | 1326477944
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Entity Type | Organization
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Legal Business Name | NORTHCARE NETWORK
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 200 W SPRING ST SUITE #2
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City | MARQUETTE
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State | MI
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Zip | 49855-4630
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Country | US
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Telephone | 906-225-7254
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Fax | 906-225-7352
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Provider Business Mailing Address
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Address Line | 200 W SPRING ST SUITE #2
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City | MARQUETTE
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State | MI
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Zip | 49855-4630
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Country | US
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Telephone | 906-225-7254
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Fax | 906-225-7352
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM SLAVIN
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Credential | MA,LLP,LMSW
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Telephone | 906-225-7253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MI
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