Provider Demographics
NPI:1982102984
Name:NORTHEAST MICHIGAN HOME HEALTH CARE
Entity Type:Organization
Organization Name:NORTHEAST MICHIGAN HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:989-646-0773
Mailing Address - Street 1:2060 RIVERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-8021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-974-1890
Practice Address - Street 1:2060 RIVERS EDGE DR
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-8021
Practice Address - Country:US
Practice Address - Phone:989-335-5606
Practice Address - Fax:888-974-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health