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General NPI Number Information
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NPI Number | 1396724332
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Entity Type | Organization
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Legal Business Name | IRON RIVER CARE SERVICES INC.
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 330 LINCOLN AVE
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City | IRON RIVER
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State | MI
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Zip | 49935-8452
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Country | US
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Telephone | 906-265-5168
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Fax | 906-265-5571
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Provider Business Mailing Address
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Address Line | 330 LINCOLN AVE
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City | IRON RIVER
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State | MI
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Zip | 49935-8452
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Country | US
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Telephone | 906-265-5168
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Fax | 906-265-5571
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT W POSSANZA JR.
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Credential | NHA
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Telephone | 906-265-5168
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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 | 364040
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License Number State | MI
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