Provider Demographics
NPI:1972534469
Name:TOWNSHIP OF LELAND
Entity Type:Organization
Organization Name:TOWNSHIP OF LELAND
Other - Org Name:TOWNSHIP OF LELAND FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TOWNSHIP CLERK
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROOKFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-256-7546
Mailing Address - Street 1:P.O. BOX 578
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49654-0578
Mailing Address - Country:US
Mailing Address - Phone:231-256-7546
Mailing Address - Fax:231-256-2465
Practice Address - Street 1:201 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:MI
Practice Address - Zip Code:49654-0578
Practice Address - Country:US
Practice Address - Phone:231-256-7546
Practice Address - Fax:231-256-2465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
MI4510043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590D500080OtherBCBSM
MI182634029Medicaid
MION73800Medicare PIN