Provider Demographics
NPI:1861996464
Name:COUNTY OF BARRY
Entity type:Organization
Organization Name:COUNTY OF BARRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DEHAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-945-2407
Mailing Address - Street 1:2700 NASHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-8824
Mailing Address - Country:US
Mailing Address - Phone:269-945-2407
Mailing Address - Fax:269-945-5380
Practice Address - Street 1:2700 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-8824
Practice Address - Country:US
Practice Address - Phone:269-945-2407
Practice Address - Fax:269-945-5380
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF BARRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-20
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)