Organization Name: | LAKESHORE COMMUNITY HOSPITAL, INC. |
NPI Number: | 1174889604 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YARA VILLANUEVA (CLINIC REIMBURSEMENT COORDINATOR) |
Mailing Address: | 611 E Main St Hart |
State: | MI US |
Postal Code: | 494201190 |
Phone Number: | 2318735675 |
Fax Number: | 2318731825 |
NPI Enumeration Date: | 04/10/2012 |
NPI Last Update Date: | 04/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | AB033570 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |