Provider Demographics
NPI:1235230996
Name:SANILAC COUNTY COMMUNITY MENTAL HEALTH
Entity Type:Organization
Organization Name:SANILAC COUNTY COMMUNITY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MERRIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:810-648-4327
Mailing Address - Street 1:217 E SANILAC RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:SANDUSKY
Mailing Address - State:MI
Mailing Address - Zip Code:48471-1383
Mailing Address - Country:US
Mailing Address - Phone:810-648-4327
Mailing Address - Fax:810-648-4338
Practice Address - Street 1:217 E SANILAC RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-1383
Practice Address - Country:US
Practice Address - Phone:810-648-4327
Practice Address - Fax:810-648-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704145414251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care