| Organization Name: | INTERLOCHEN CENTER FOR THE ARTS |
| NPI Number: | 1174843353 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY L GIFFELS (DIRECTOR OF HEALTH AND WELLNESS) |
| Mailing Address: | 9900 Diamond Park Road Health Services Interlochen |
| State: | MI US |
| Postal Code: | 496430199 |
| Phone Number: | 2312767220 |
| Fax Number: | 2312767881 |
| NPI Enumeration Date: | 06/10/2010 |
| NPI Last Update Date: | 06/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704114336 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |