Provider Demographics
NPI:1477654127
Name:REGION VII AREA AGENCY ON AGING INC
Entity Type:Organization
Organization Name:REGION VII AREA AGENCY ON AGING INC
Other - Org Name:SUNRISE PACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-893-4506
Mailing Address - Street 1:1615 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3319
Mailing Address - Country:US
Mailing Address - Phone:989-893-4506
Mailing Address - Fax:989-893-4506
Practice Address - Street 1:5229 LAKESHORE ROAD
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059
Practice Address - Country:US
Practice Address - Phone:810-388-6300
Practice Address - Fax:810-388-6305
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
207Q00000X, 251T00000X, 261Q00000X, 333600000X, 363L00000X
MI251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No333600000XSuppliersPharmacyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4509404OtherTARGETED CARE MANAGEMENT
MI4508917Medicaid