Provider Demographics
NPI:1558113282
Name:CHARISSE SUSZEK
Entity Type:Organization
Organization Name:CHARISSE SUSZEK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH AIDE
Authorized Official - Prefix:
Authorized Official - First Name:CHARISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-884-1674
Mailing Address - Street 1:308 S 8TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2583
Mailing Address - Country:US
Mailing Address - Phone:989-884-1674
Mailing Address - Fax:
Practice Address - Street 1:150 WENONAH DR APT 11
Practice Address - Street 2:
Practice Address - City:ROGERS CITY
Practice Address - State:MI
Practice Address - Zip Code:49779-2102
Practice Address - Country:US
Practice Address - Phone:989-884-1674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health