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General NPI Number Information
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NPI Number | 1518957208
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Entity Type | Organization
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Legal Business Name | MANISTEE BENZIE CMH
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 6051 FRANKFORT HWY SUITE 200
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City | BENZONIA
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State | MI
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Zip | 49616-9558
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Country | US
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Telephone | 877-398-2013
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Fax | 231-882-2195
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Provider Business Mailing Address
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Address Line | 310 GLOCHESKI DR PO BOX 335
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City | MANISTEE
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State | MI
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Zip | 49660-2639
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Country | US
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Telephone | 877-398-2013
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Fax | 231-723-1504
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Authorized Official
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Title or Position | FINANCE OFFICER
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Name | MS. DONNA NIEMAN
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Credential |
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Telephone | 877-398-2013
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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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