Provider Demographics
NPI:1124611769
Name:BAY SHORE EVANGELICAL CAMP OF THE UMC
Entity type:Organization
Organization Name:BAY SHORE EVANGELICAL CAMP OF THE UMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-883-2501
Mailing Address - Street 1:PO BOX 624
Mailing Address - Street 2:
Mailing Address - City:SEBEWAING
Mailing Address - State:MI
Mailing Address - Zip Code:48759-0624
Mailing Address - Country:US
Mailing Address - Phone:989-883-2501
Mailing Address - Fax:
Practice Address - Street 1:450 N MILLER ST
Practice Address - Street 2:
Practice Address - City:SEBEWAING
Practice Address - State:MI
Practice Address - Zip Code:48759-1035
Practice Address - Country:US
Practice Address - Phone:989-883-2501
Practice Address - Fax:989-883-3930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp