=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700978632
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIVINGSTON COUNTY TREASURER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2006
-----------------------------------------------------
Last Update Date | 07/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 E. GRAND RIVER AVE SUITE 102
-----------------------------------------------------
City | HOWELL
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-546-9850
-----------------------------------------------------
Fax | 517-546-6995
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2300 E. GRAND RIVER AVE SUITE 102
-----------------------------------------------------
City | HOWELL
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-546-9850
-----------------------------------------------------
Fax | 517-546-6995
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEALTH OFFICER
-----------------------------------------------------
Name | MATT BOLANG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 517-546-9850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------