| Organization Name: | PORTAGE HEALTH INC |
| NPI Number: | 1184786188 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES BOGAN (CEO) |
| Mailing Address: | 500 Campus Dr Hancock |
| State: | MI US |
| Postal Code: | 499301569 |
| Phone Number: | 9064831720 |
| Fax Number: | 9064831735 |
| NPI Enumeration Date: | 12/15/2006 |
| NPI Last Update Date: | 08/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |