Provider Demographics
NPI:1205807989
Name:MERCY NORTH HOMECARE & HOSPICE
Entity type:Organization
Organization Name:MERCY NORTH HOMECARE & HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIERANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-712-9550
Mailing Address - Street 1:PO BOX 9185
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-9185
Mailing Address - Country:US
Mailing Address - Phone:734-542-8220
Mailing Address - Fax:734-542-8286
Practice Address - Street 1:7985 MACKINAW TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8111
Practice Address - Country:US
Practice Address - Phone:231-712-9550
Practice Address - Fax:231-779-9554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI843511251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3439682Medicaid
MI08780OtherBLUE CROSS
MI3439682Medicaid