Provider Demographics
NPI:1679738389
Name:NORTHERN HOMECARE SERVICES
Entity type:Organization
Organization Name:NORTHERN HOMECARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-786-4701
Mailing Address - Street 1:P.O. BOX 643
Mailing Address - Street 2:2501 14TH AVENUE SOUTH
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829
Mailing Address - Country:US
Mailing Address - Phone:906-217-3034
Mailing Address - Fax:906-217-3039
Practice Address - Street 1:2501 14TH AVE S
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1136
Practice Address - Country:US
Practice Address - Phone:906-217-3017
Practice Address - Fax:906-789-5853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care