Organization Active NPI

Marquette Staffing Agency, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Marquette, MI
National Provider Identifier
1508334764
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
MARQUETTE STAFFING AGENCY, INC.
Practice address
592 Blemhuber Ave
Marquette, MI 49855-4818
Phone
(906) 235-8311
NPI assigned
Nov 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Authorized official

Name
Melissa B. Wernholm, B.S.
Title
President
Phone
(906) 235-8311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

592 Blemhuber Ave
Marquette, MI 49855-4818

Mailing address

PO Box 666
Marquette, MI 49855-0666
Phone (906) 235-8311

Other identifiers 1

IdentifierTypeStateIssuer
7520051MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1508334764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 666",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498550666",
            "telephone_number": "906-235-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 BLEMHUBER AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554818",
            "telephone_number": "906-235-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARQUETTE STAFFING AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "WERNHOLM",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-235-8311",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7520051",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.