Provider Demographics
NPI:1013086313
Name:DISTRICT HEALTH DEPARTMENT NO 2
Entity Type:Organization
Organization Name:DISTRICT HEALTH DEPARTMENT NO 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH SERVICES DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:C
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:989-343-1808
Mailing Address - Street 1:630 PROGRESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-8603
Mailing Address - Country:US
Mailing Address - Phone:989-343-1808
Mailing Address - Fax:989-343-1897
Practice Address - Street 1:630 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-8603
Practice Address - Country:US
Practice Address - Phone:989-343-1808
Practice Address - Fax:989-343-1897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI658610251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI203977OtherHOME HEALTH CARE MCLAREN
MI0E052OtherHOME HEALTH CARE BCBS
MI5173874Medicaid
MI237052Medicare ID - Type UnspecifiedHOME HEALTH CARE MEDICARE