Luce-Mackinac Health Department

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LUCE-MACKINAC HEALTH DEPARTMENT

Practice address

14150 Hamilton Lake Road
Newberry, MI 49868

Phone

(906) 293-5107

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Marvin H Henderson

Title

Administrator

Phone

(906) 293-5107

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1700915709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 HAMILTON LAKE ROAD",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "49868",
            "telephone_number": "906-293-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 HAMILTON LAKE ROAD",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "49868",
            "telephone_number": "906-293-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCE-MACKINAC HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "906-293-5107"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2823509",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Ballard Behavioral Health Services LLC
• Eric Steven Laroue, D.D.S.
• Luce-Mackinac District Health Department
• Luce-Mackinac Health Department
• Luce-Mackinac Health Department
• M K Stores Inc
• M.K. Stores, Inc
• Elizabeth Magyar, LLMSW
• Latasha Martin, RN, BSN
• Danette Lynn Martyn, NURSE PRACTITIONER

• All providers in Newberry, MI
• Community Based Hospice Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.