Provider Demographics
NPI:1851477699
Name:VISITING NURSE ASSOCIATION OF SAGINAW
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF SAGINAW
Other - Org Name:COVENANT VISITING NURSE ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLASGOW
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:989-799-6020
Mailing Address - Street 1:500 S HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-1511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 S HAMILTON ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-1511
Practice Address - Country:US
Practice Address - Phone:989-799-6020
Practice Address - Fax:989-583-1745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RH0002X
MI733511251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2598352Medicaid
MI4982620Medicaid
MI2598352Medicaid