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NPI Code Detail

MEDICARE: HOLLY SMITH SSCA

MEDICARE: HOLLY SMITH SSCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorMI

General Provider Information

NPI Number : 1811850233
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY SMITH SSCA
Provider Business Mailing Address
First Line : 1199 HARRIS AVE
Second Line :
City : TAWAS CITY
State : MI
Zip : 48763-9681
Country : US
Telephone Number : 517-841-4210
Fax Number :
Provider Business Practice Location Address
First Line : 1199 HARRIS AVE
Second Line :
City : TAWAS CITY
State : MI
Zip : 48763-9681
Country : US
Telephone Number : 517-841-4210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ HOLLY SMITH SSCA” Practice Location

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