Organization Name: | PSYCHNORTH |
NPI Number: | 1063887230 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JO ANN HADERER (OFFICE MANAGER) |
Mailing Address: | 2202 Mitchell Park Dr Ste 5 Petoskey |
State: | MI US |
Postal Code: | 497708897 |
Phone Number: | 2313485018 |
Fax Number: | 8447110200 |
NPI Enumeration Date: | 12/14/2015 |
NPI Last Update Date: | 12/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 4301089286 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |