Provider Demographics
NPI:1902122005
Name:WHISPERING PINES
Entity Type:Organization
Organization Name:WHISPERING PINES
Other - Org Name:GREAT NORTHERN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-497-5580
Mailing Address - Street 1:N16003 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POWERS
Mailing Address - State:MI
Mailing Address - Zip Code:49874-9607
Mailing Address - Country:US
Mailing Address - Phone:906-497-5580
Mailing Address - Fax:
Practice Address - Street 1:N16003 MAIN ST
Practice Address - Street 2:
Practice Address - City:POWERS
Practice Address - State:MI
Practice Address - Zip Code:49874-9607
Practice Address - Country:US
Practice Address - Phone:906-497-5580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINECREST MEDICAL CARE FACILITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care