Organization Active NPI

Huron County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Bad Axe, MI
National Provider Identifier
1669796694
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HURON COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Doing business as
Huron Behavioral Health
Practice address
1375 R Dale Wertz Dr
Bad Axe, MI 48413
Phone
(989) 269-9293
Fax
(989) 269-7544
NPI assigned
Mar 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Authorized official

Name
Jeanette Johnson
Title
Reimbursement Coordinator
Phone
(989) 269-1129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1375 R Dale Wertz Dr
Bad Axe, MI 48413

Mailing address

1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365
Phone (989) 269-9293

Other practice location 1

1108 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9293

Other identifiers 2

IdentifierTypeStateIssuer
774352852MedicaidMI
7509109570OtherMIBCBS

Other names 1

  • Huron Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Huron Cnty Community Mental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1669796694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 R DALE WERTZ DR",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131365",
            "telephone_number": "989-269-9293",
            "fax_number": "989-269-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 R DALE WERTZ DR",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "48413",
            "telephone_number": "989-269-9293",
            "fax_number": "989-269-7544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 S Van Dyke Rd",
            "address_purpose": "LOCATION",
            "city": "Bad Axe",
            "state": "MI",
            "postal_code": "484139615",
            "country_code": "US",
            "telephone_number": "989-269-9293",
            "fax_number": "989-269-7544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HURON COUNTY COMMUNITY MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "REIMBURSEMENT COORDINATOR",
        "authorized_official_telephone_number": "989-269-1129"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774352852",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7509109570",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huron Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Huron Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.