North Shores Center, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

NORTH SHORES CENTER, LLC

Practice address

6193 Norway Rd
Oscoda, MI 48750-8739

Phone

(989) 569-3772

NPI assigned

May 30, 2019

Organization subpart

No

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

Authorized official

Name

Jill Lebourdais, PA-CNPI 1447216999

Title

Licensee

Phone

(989) 493-1451

Specialties & licenses 1

Addresses

Tax ID family

North Shores Center LLC2 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.

• North Shores Center, LLC

  • Psychiatric Residential Treatment Facility
  • Gaylord, MI
  • NPI 1700657905
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• North Shores Center, LLC

  • Psychiatric Residential Treatment Facility
  • Gaylord, MI
  • NPI 1700657905
  NPPES parent name

Practitioners 1

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

• Jill Anne Lebourdais, PA

  • Medical Physician Assistant
  • Saginaw, MI
  • NPI 1447216999
  NPD Authorized official

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1962060541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 WINTERWOOD LN",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486038673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6193 NORWAY RD",
            "city": "OSCODA",
            "state": "MI",
            "postal_code": "487508739",
            "telephone_number": "989-569-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORES CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LEBOURDAIS",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "989-493-1451",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mymichigan Medical Center Alpena
• Mymichigan Medical Center Tawas
• Kristen Nance, PH.D.
• Willow Newman, MS
• Catherine Nickell-Simpson, LMSW
• Northern Foot & Ankle Centers PC
• Oscoda Area Chiropractic Center Inc
• Oscoda Area First Responders
• Oscoda Community Pharmacy
• Oscoda VA Outpatient Clinic

• All providers in Oscoda, MI
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.