Provider Demographics
NPI:1326477944
Name:NORTHCARE NETWORK
Entity Type:Organization
Organization Name:NORTHCARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LLP,LMSW
Authorized Official - Phone:906-225-7253
Mailing Address - Street 1:200 W SPRING ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4630
Mailing Address - Country:US
Mailing Address - Phone:906-225-7254
Mailing Address - Fax:906-225-7352
Practice Address - Street 1:200 W SPRING ST
Practice Address - Street 2:SUITE #2
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4630
Practice Address - Country:US
Practice Address - Phone:906-225-7254
Practice Address - Fax:906-225-7352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health