NORTHERN MICHIGAN SUBSTANCE ABUSE SERVICES, INC. (NPI# 1164641676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164641676 |
| Entity Type | Organization |
| Organization Name | NORTHERN MICHIGAN SUBSTANCE ABUSE SERVICES, INC. |
| Practice Address |
2136 W M 32 Gaylord MI 49735-9282 |
| Practice Telephone | 9897321791 |
| Practice Fax Number | 9897327052 |
| Mailing Telephone | 9897321791 |
| Mailing Fax Number | 9897327052 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2014-10-27 |
| Authorized Official Name | SUE WINTER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9897321791 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | SA0690031 | MI | Agencies |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
690031 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 174458207 | 05 |
| Street Address |
2136 W M 32 |
| City | GAYLORD |
| State | MI |
| Zip Code | 49735-9282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700306669 | Carissa Jara | Case Manager/Care Coordinator | 2136 W M 32, Gaylord, MI 49735-9282 | 2017-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447453 | Jenni Kirt | Social Worker | 407 I-75 Bus N, Gaylord, MI 49735 | 2020-11-05 |
| 1922584986 | Patricia Dovalina | Behavior Technician | 2285 Michaywe Dr, Otsego Lake, MI 49735 | 2018-07-12 |
| 1265944581 | James Hulbert | Social Worker | 407 W Main Street, Gaylord, MI 49735 | 2017-10-26 |
| 1548792625 | Somer Lawes | Behavior Technician | 2443 Castlewood Dr, Gaylord, MI 49735 | 2017-03-29 |
| 1922554161 | Mark David Mcpherson | Counselor | 2136 West M-32, Gaylord, MI 49735 | 2016-08-28 |
| 1689063034 | Liza Brandt | Behavioral Analyst | 6748 Colonial Ct, Gaylord, MI 49735 | 2015-01-22 |
| 1942597224 | Visions for Your Community Care Hhc | Home Health | 2365 N Perch Lake Dr, Gaylord, MI 49735 | 2011-07-07 |
| 1073778304 | Julie Lynn Vandusen | Community Health Worker | 5512 Clubhouse Trail, Gaylord, MI 49735 | 2008-07-25 |
| 1073708798 | Alpine Chiropractic, PC | Chiropractor | 529 S. Wisconsin Ave, Gaylord, MI 49735 | 2007-09-06 |
| 1669675567 | Oral and Maxillofacial Surgery Associates | Dentist | 785 E M32, Gaylord, MI 49735 | 2007-06-07 |
| Find all providers in zip 49735 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1679714083 | Great Lakes Recovery Centers, Inc. | Clinic/Center | 1401 N. 26th Street, Suite 109, Escanaba, MI 49801 | 2009-03-13 |
| 1962606632 | St Johns Home | Clinic/Center | 2355 Knapp St Ne, Grand Rapids, MI 49505-4415 | 2007-06-14 |
| 1699981498 | West Michigan Therapy Inc | Clinic/Center | 130 E Apple Ave, Muskegon, MI 49442-3405 | 2007-05-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.