Provider Demographics
NPI:1548360787
Name:MAR-CO DEVELOPMENTS
Entity type:Organization
Organization Name:MAR-CO DEVELOPMENTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:DUCHARME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-319-5808
Mailing Address - Street 1:306 S CREYTS RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-8289
Mailing Address - Country:US
Mailing Address - Phone:517-319-5808
Mailing Address - Fax:517-319-5872
Practice Address - Street 1:316 S. CREYTS
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917
Practice Address - Country:US
Practice Address - Phone:517-319-5808
Practice Address - Fax:517-319-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30785Medicare UPIN
MI6470075Medicare UPIN
MI23530Medicare ID - Type Unspecified