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Organization
BLUE WATER SLEEP INC
Active
Organization
BLUE WATER SLEEP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HEANEY NP (MANAGER)
(586) 524-5801
Entity
Organization
Contact information
Practice address
5316 LAKESHORE RD, FORT GRATIOT, MI 48059-3118
(810) 357-8792
Mailing address
5316 LAKESHORE RD, FORT GRATIOT, MI 48059-3118
(810) 357-8792
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163WC1500X
Community Health Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
364SH0200X
Home Health Clinical Nurse Specialist
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/28/2023
Last updated
11/12/2023
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