St. Ann'S Lake County Senior

Primary specialty

Meals ProviderTaxonomy code 174200000X

Legal business name

ST. ANN'S LAKE COUNTY SENIOR

Practice address

690 E 9TH St
Baldwin, MI 49304-7557

Phone

(231) 745-7202

Fax

(231) 745-3656

NPI assigned

Apr 16, 2024

Organization subpart

No

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

Authorized official

Name

Shelly Ann Shafer

Title

Director

Phone

(231) 745-7201

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1699529586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "BALDWIN",
            "state": "MI",
            "postal_code": "493040040",
            "telephone_number": "231-745-7201",
            "fax_number": "231-745-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E 9TH ST",
            "city": "BALDWIN",
            "state": "MI",
            "postal_code": "493047557",
            "telephone_number": "231-745-7202",
            "fax_number": "231-745-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANN'S LAKE COUNTY SENIOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "231-745-7201"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felisha Robinson, LMSW
• Emilee Rose Sheeley
• Jennifer Marie Shepard
• Cynthia Lucille Sherwood, FNP-BC
• Debra Sowle
• Ian G Stambersky
• Jurrica Justyne Stanley, RDH
• Elizabeth Jean Steckel, CHW
• Matthew J Steel, PA
• Cathy Sullivan, LMSW

• Meals Provider in Baldwin, MI
• Providers in Baldwin, MI by specialty
• Meals Provider in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.