Provider Demographics
NPI:1932143682
Name:MCLAREN HEALTH MANAGEMENT GROUP
Entity Type:Organization
Organization Name:MCLAREN HEALTH MANAGEMENT GROUP
Other - Org Name:VISITING NURSE SERVICES OF MICHIGAN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:LOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-496-8633
Mailing Address - Street 1:1515 CAL DR
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-9016
Mailing Address - Country:US
Mailing Address - Phone:800-862-3132
Mailing Address - Fax:866-571-9636
Practice Address - Street 1:2110 16TH ST
Practice Address - Street 2:STE 7
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7609
Practice Address - Country:US
Practice Address - Phone:800-862-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI15 4611990Medicaid
MI=========OtherTAX IDENTIFICATION
MI15 4611990Medicaid