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General NPI Number Information
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NPI Number | 1700891504
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Entity Type | Organization
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Legal Business Name | U.P. ELDERCARE, LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 634 E AYER ST
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City | IRONWOOD
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State | MI
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Zip | 49938-2206
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Country | US
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Telephone | 906-932-2006
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Fax | 906-932-1380
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Provider Business Mailing Address
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Address Line | 634 E AYER ST
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City | IRONWOOD
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State | MI
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Zip | 49938-2206
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Country | US
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Telephone | 906-932-2006
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Fax | 906-932-1380
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Authorized Official
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Title or Position | CFO
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Name | TERESA C STANFIELD
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Credential |
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Telephone | 906-932-2006
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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 | 274010
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License Number State | MI
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