| Organization Name: | NORTH COUNTRY HEALTHCARE, INC. |
| NPI Number: | 1275657363 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANN M. ROGGENBUCK (CEO) |
| Mailing Address: | 620 West Lee St Winslow |
| State: | AZ US |
| Postal Code: | 860472435 |
| Phone Number: | 9282892000 |
| Fax Number: | 9282890036 |
| NPI Enumeration Date: | 03/16/2007 |
| NPI Last Update Date: | 06/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | OTC3455 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |