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General NPI Number Information
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NPI Number | 1699164244
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF HUMAN SERVICES
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 203 MAPLE ST
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City | AMASA
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State | MI
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Zip | 49903-0031
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Country | US
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Telephone | 906-203-9154
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31
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City | AMASA
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State | MI
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Zip | 49903-0031
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Country | US
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Telephone | 906-203-9154
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MRS. DONNA AHLBERG
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Credential |
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Telephone | 906-399-9219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0141620
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License Number State | MI
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