HIAWATHA BEHAVIORAL HEALTH (NPI# 1417275140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417275140 |
| Entity Type | Organization |
| Organization Name | HIAWATHA BEHAVIORAL HEALTH |
| Practice Address |
3865 S Mackinac Trl Sault Sainte Marie MI 49783-9286 |
| Mailing Address |
125 N Lake St Manistique MI 49854-1234 |
| Practice Telephone | 9066322805 |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2010-05-19 |
| Authorized Official Name | SAMUEL HARMA (CEO) |
| Authorized Official Telephone | 9063412144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE GROUP NUMBER | 0M49670 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HIAWATHA BEHAVIORAL HEALTH | 125 N Lake St, Manistique, MI 49854-1234 |
| Street Address |
3865 S MACKINAC TRL |
| City | SAULT SAINTE MARIE |
| State | MI |
| Zip Code | 49783-9286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629161567 | Hiawatha Community Behavioral Health Authority | Community/Behavioral Health | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2006-10-02 |
| 1336758689 | Austin Lowes | Social Worker | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2020-07-23 |
| 1598381394 | Kayla Davis | Registered Nurse | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2020-06-18 |
| 1699313163 | Colton Korhonen | Registered Nurse | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2019-12-16 |
| 1013555895 | Aubree Archer | Behavior Technician | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2019-12-12 |
| 1235776527 | Natalie Olstrom | Behavior Technician | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2019-12-05 |
| 1497392799 | Haley Brown | Behavior Technician | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2019-12-05 |
| 1548736176 | Bonita Bundy | Registered Nurse | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2018-10-22 |
| 1154811032 | Bradley Benslow | Registered Nurse | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2018-05-16 |
| 1073024907 | Caroline Jeannette Keller | Social Worker | 3865 S Mackinac Trl, Sault Sainte Marie, MI 49783-9286 | 2017-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541305 | Kevin P Cooper Dds PC | Dentist | 202 Brady Street, Sault Sainte Marie, MI 49783 | 2020-09-04 |
| 1033767512 | Louis William Bergman | Pharmacist | 3763 75 Business Spur, Sault Ste Marie, MI 49783 | 2019-08-28 |
| 1972076818 | Phyllis Mary Robertson | Speech-Language Pathologist | 2472 Ashmun Street, War Memorial Hospital Rehabilitation Centre, Sault Sainte Marie, MI 49783 | 2019-01-03 |
| 1831611748 | Thomas Matthew Choponis | Optometrist | 128 W Spruce St Ste 1, Sault Sainte Marie, MI 49783 | 2017-07-12 |
| 1730633223 | Holly D Statt | Dental Hygienist | 905 Marquette Ave, Sault Sainte Marie, MI 49783 | 2016-08-12 |
| 1316306590 | Debra Joyce Peake | Social Worker | 3865 South Mackinac Trail, Sault Ste Marie, MI 49783 | 2016-02-17 |
| 1629465935 | Jodi Johnson | Occupational Therapy Assistant | 1011 Merridian St, Sault Saint Marie, MI 49783 | 2015-04-24 |
| 1972885606 | Elizabeth Hayes | Social Worker | 3865 S Mackinac Trail, Sault Ste Marie, MI 49783 | 2011-09-20 |
| 1922252618 | Denise L. Montgomery | Registered Nurse | 500 Osborn Blvd., Sault Ste Marie, MI 49783 | 2008-11-08 |
| 1487829826 | Melanie A Cook | Eyewear Supplier (Equipment, not the service) | 1908 Ashman Street, Sault Ste Marie, MI 49783 | 2008-04-28 |
| Find all providers in zip 49783 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972703536 | Amged Abdelmonim Tagelsir Abdelaziz | Internal Medicine | 560 Osborn Blvd Unit 2e, Sault Sainte Marie, MI 49783-1985 | 2007-07-23 |
| 1760698484 | Thilak Chander | Internal Medicine | 511 Ashmun St, Suite 102, Sault Sainte Marie, MI 49783-1960 | 2007-05-16 |
| 1760572002 | Mohammed D Haider | Internal Medicine | 509 Osborn Blvd Ste 340, Sault Sainte Marie, MI 49783-2071 | 2006-10-16 |
| 1679667687 | Lakeview Internal Medicine,p.c | Internal Medicine | 558 Ashmun St, Sault Sainte Marie, MI 49783-4001 | 2006-10-03 |
| 1295153724 | Rashad Farha | Internal Medicine | 500 Osborn Blvd, Sault Sainte Marie, MI 49783 | 2014-04-02 |
| 1568718062 | Dlp Marquette Physician Practices Inc | Internal Medicine | 510 Ashmun St, Ste 5, Sault Sainte Marie, MI 49783-1964 | 2012-08-02 |
| 1588897086 | Arthur Luka | Internal Medicine | 500 Osborn Blvd, Sault Sainte Marie, MI 49783-1822 | 2009-08-31 |
| 1952535049 | Nessrine Hussein Ktaich | Internal Medicine | 500 Osborn Blvd, Sault Sainte Marie, MI 49783-1822 | 2009-05-05 |
| 1235316506 | Eero J. Ranta, M.d., P.C. | Internal Medicine | 550 Osborn Blvd, Suite 204, Sault Sainte Marie, MI 49783-1899 | 2008-01-29 |
| 1548225170 | Eero J Ranta | Internal Medicine | 550 Osborn Blvd, Suite 204, Sault Sainte Marie, MI 49783-1899 | 2006-04-18 |
| Find all providers in SAULT SAINTE MARIE | ||||
| City | SAULT SAINTE MARIE |
| Zip Code | 49783 |
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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.