# HOUGHTON COUNTY MEDICAL CARE FACILITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Canal View Houghton County
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083607139
- **Authorized official:** MS. DENISE M BRISEBOIS SENIOR BILLING SPECI (SENIOR BILLING SPECIALIST)
- **Authorized official phone:** (906) 483-2153

## Contact information

- **Practice address:** 1100 W QUINCY ST, HANCOCK, MI 49930-1404
- **Practice address phone:** (906) 482-5050
- **Practice address fax:** (906) 482-4609
- **Mailing address:** 1100 W QUINCY ST, HANCOCK, MI 49930-1404
- **Mailing address phone:** (906) 482-5050
- **Mailing address fax:** (906) 482-4609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 318510 | MI | Yes |

## Other

- **Enumeration date:** 08/24/2005
- **Last updated:** 06/25/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09620 | BLUE CROSS | MI |
| 05 | — | 2085034 | — | MI |