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General NPI Number Information
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NPI Number | 1447928023
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Entity Type | Organization
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Legal Business Name | ITH OF MICHIGAN LLC
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 415 JEROME ST
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City | MIDLAND
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State | MI
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Zip | 48640-4960
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Country | US
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Telephone | 989-631-0080
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Fax | 989-631-1825
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Provider Business Mailing Address
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Address Line | 415 JEROME ST
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City | MIDLAND
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State | MI
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Zip | 48640-4960
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Country | US
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Telephone | 989-631-0080
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Fax | 989-631-1825
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Authorized Official
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Title or Position | ACCESS MANAGER
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Name | SUSAN KAY SCHALK
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Credential |
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Telephone | 989-631-0080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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