Provider Demographics
NPI:1568449684
Name:COUNTY OF HILLSDALE
Entity Type:Organization
Organization Name:COUNTY OF HILLSDALE
Other - Org Name:HILLSDALE COUNTY MEDICAL CARE FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NHA, MBA
Authorized Official - Phone:517-439-9341
Mailing Address - Street 1:140 W. MECHANIC ROAD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242
Mailing Address - Country:US
Mailing Address - Phone:517-439-9341
Mailing Address - Fax:517-439-9839
Practice Address - Street 1:140 W. MECHANIC ROAD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242
Practice Address - Country:US
Practice Address - Phone:517-439-9341
Practice Address - Fax:517-439-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI308510314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2085375Medicaid
MI235197Medicare Oscar/Certification
MI235197Medicare UPIN