Organization Active NPI

Houghton County Medical Care Facility

Doing business as Canal View Houghton County

  • Skilled Nursing Facility
  • Hancock, MI
National Provider Identifier
1083607139
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
318510 Issued in MI
Legal business name
HOUGHTON COUNTY MEDICAL CARE FACILITY
Doing business as
Canal View Houghton County
Practice address
1100 W Quincy St
Hancock, MI 49930-1404
Phone
(906) 482-5050
Fax
(906) 482-4609
NPI assigned
Aug 24, 2005
Last updated
Jun 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Denise M Brisebois, SENIOR BILLING SPECI
Title
Senior Billing Specialist
Phone
(906) 483-2153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 318510 MI Primary

Addresses

Primary practice location

1100 W Quincy St
Hancock, MI 49930-1404

Mailing address

1100 W Quincy St
Hancock, MI 49930-1404
Phone (906) 482-5050

Other identifiers 2

IdentifierTypeStateIssuer
2085034MedicaidMI
09620OtherMIBLUE CROSS

Other names 1

  • Canal View Houghton County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120114000058 MI Part A Provider - Skilled Nursing Facility 8820265846 Practice locations: Hancock, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083607139. Details of each certification follow.

Skilled nursing facility certification: CCN 235031

Legal name
HOUGHTON COUNTY MEDICAL CARE FACILITY
Doing business as
CANAL VIEW HOUGHTON COUNTY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Nov 20, 2024
Beds
197
Ownership / control type
City/County
Organization structure
OtherNon-profit
Enrollment address
1100 W Quincy St
Hancock, MI 49930-1404
Nursing home name
CANAL VIEW - HOUGHTON COUNTY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Canal View - Houghton CountyCCN 235031 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - City/county
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
197131.7 residents per day on average
Penalties (3 years)
3Fines totaling $39,988

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0724364Canal View-Houghton County1100 W Quincy Street, Hancock, MI 49930Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kara Destrampe Individual Operational/Managerial Control Jan 15, 2025
Edward Jenich Individual Managing Control - Governing BodyBoard Chair Jan 1, 2013
Adam Laplander Individual Operational/Managerial Control Sep 1, 2023
Adp of the SNF Mar 24, 2025
Christy Hilgers Individual Managing Control - Governing BodyVice Chair Nov 1, 2010
James Tervo Individual Managing Control - Governing BodyBoard Member Jan 1, 2020
Houghton County Medical Care Facility Organization, Hancock, MI Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1968 100%
Operational/Managerial Control Aug 6, 1996 100%
Ashley Kuru Individual Operational/Managerial Control Jan 15, 2025
Terry Kinzel Individual Operational/Managerial Control Jan 24, 2025
Adp of the SNF Jan 24, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1083607139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W QUINCY ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301404",
            "telephone_number": "906-482-5050",
            "fax_number": "906-482-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W QUINCY ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301404",
            "telephone_number": "906-482-5050",
            "fax_number": "906-482-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUGHTON COUNTY MEDICAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "BRISEBOIS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR BILLING SPECIALIST",
        "authorized_official_telephone_number": "906-483-2153",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "SENIOR BILLING SPECI"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "318510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085034",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "09620",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canal View Houghton County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.