Organization Name: | BAY MILLS INDIAN COMMUNITY |
NPI Number: | 1053592089 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AUDREY BREAKIE (HEALTH DIRECTOR) |
Mailing Address: | 12124 W Lakeshore Dr Brimley |
State: | MI US |
Postal Code: | 497159319 |
Phone Number: | 9062485527 |
Fax Number: | 9062485765 |
NPI Enumeration Date: | 11/19/2007 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |