Provider Demographics
NPI:1013088079
Name:COUNTY OF LAPEER
Entity Type:Organization
Organization Name:COUNTY OF LAPEER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR HEALTH OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MPA
Authorized Official - Phone:810-245-5581
Mailing Address - Street 1:1800 IMLAY CITY RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3208
Mailing Address - Country:US
Mailing Address - Phone:810-245-5711
Mailing Address - Fax:810-245-4525
Practice Address - Street 1:1800 IMLAY CITY RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3208
Practice Address - Country:US
Practice Address - Phone:810-245-5711
Practice Address - Fax:810-245-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23D0650909163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4695060Medicaid
MI1845691Medicaid
MI5100546Medicaid