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General NPI Number Information
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NPI Number | 1508334764
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Entity Type | Organization
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Legal Business Name | MARQUETTE STAFFING AGENCY, INC.
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 592 BLEMHUBER AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-4818
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Country | US
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Telephone | 906-235-8311
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 666
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City | MARQUETTE
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State | MI
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Zip | 49855-0666
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Country | US
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Telephone | 906-235-8311
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELISSA B. WERNHOLM
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Credential | B.S.
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Telephone | 906-235-8311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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