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General NPI Number Information
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NPI Number | 1376535609
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Entity Type | Organization
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Legal Business Name | JACKSON COUNTY MEDICAL CARE FACILITY
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 524 LANSING AVE
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City | JACKSON
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State | MI
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Zip | 49201-2804
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Country | US
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Telephone | 517-782-8500
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Fax | 517-789-5762
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Provider Business Mailing Address
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Address Line | 524 LANSING AVE
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City | JACKSON
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State | MI
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Zip | 49201-2804
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Country | US
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Telephone | 517-782-8500
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Fax | 517-789-5762
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | MR. JOHN R STEELE
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Credential |
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Telephone | 517-782-8500
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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 | 38851
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License Number State | MI
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