Provider Demographics
NPI:1821218355
Name:NORTHERN MICHIGAN RE-INTEGRATION SERVICES, INC.
Entity Type:Organization
Organization Name:NORTHERN MICHIGAN RE-INTEGRATION SERVICES, INC.
Other - Org Name:NORTHERN PATHWAYS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LLP, LPC
Authorized Official - Phone:989-732-4550
Mailing Address - Street 1:651 N OTSEGO AVE
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1531
Mailing Address - Country:US
Mailing Address - Phone:989-732-4550
Mailing Address - Fax:989-732-2551
Practice Address - Street 1:651 N OTSEGO AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1531
Practice Address - Country:US
Practice Address - Phone:989-732-4550
Practice Address - Fax:989-732-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness