Provider Demographics
NPI:1457353146
Name:COUNTY OF BARRY
Entity Type:Organization
Organization Name:COUNTY OF BARRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHUMWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-945-2942
Mailing Address - Street 1:206 W COURT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1874
Mailing Address - Country:US
Mailing Address - Phone:877-489-9084
Mailing Address - Fax:269-948-3317
Practice Address - Street 1:206 W COURT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1874
Practice Address - Country:US
Practice Address - Phone:877-489-9084
Practice Address - Fax:269-948-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI080001261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)