Roscommon County Commission on Aging

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ROSCOMMON COUNTY COMMISSION ON AGING

Practice address

1015 Short Dr Ste a
Prudenville, MI 48651-8450

Phone

(989) 366-0205

Fax

(989) 366-0136

NPI assigned

Apr 3, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Debra Looney

Title

Director

Phone

(989) 366-0205

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1437901501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SHORT DR STE A",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486518450",
            "telephone_number": "989-366-0205",
            "fax_number": "989-366-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 SHORT DR STE A",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486518450",
            "telephone_number": "989-366-0205",
            "fax_number": "989-366-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSCOMMON COUNTY COMMISSION ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "LOONEY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "989-366-0205",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Prudenville, MI
• Providers in Prudenville, MI by specialty
• In Home Supportive Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.