Provider Demographics
NPI:1497551576
Name:CHIPPEWA COUNTY HEALTH DEPARTMENT SHACC
Entity type:Organization
Organization Name:CHIPPEWA COUNTY HEALTH DEPARTMENT SHACC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SENKUS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:906-253-3103
Mailing Address - Street 1:508 ASHMUN ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1976
Mailing Address - Country:US
Mailing Address - Phone:906-253-3103
Mailing Address - Fax:
Practice Address - Street 1:904 MARQUETTE AVE RM 622
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3301
Practice Address - Country:US
Practice Address - Phone:906-635-1566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care