Provider Demographics
NPI:1184695850
Name:MERCY NORTH HOMECARE AND HOSPICE
Entity type:Organization
Organization Name:MERCY NORTH HOMECARE AND HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIERANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-348-4383
Mailing Address - Street 1:PO BOX 9185
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-9185
Mailing Address - Country:US
Mailing Address - Phone:734-542-8213
Mailing Address - Fax:734-542-8286
Practice Address - Street 1:324 MEADOWS DR
Practice Address - Street 2:SUITE A
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-2015
Practice Address - Country:US
Practice Address - Phone:989-348-4380
Practice Address - Fax:989-348-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI203600251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI08781OtherBLUE CROSS
MI3439673Medicaid
MI3439673Medicaid