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Organization
STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Active
Organization
STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Active
Parent organization
STATE OF MICHIGAN
Other names
D.J. Jacobetti Home for Veterans
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF MICHIGAN
Authorized official
RONALD OJA (ADMINISTRATOR)
(906) 226-3576
Entity
Organization
Contact information
Practice address
425 FISHER ST, MARQUETTE, MI 49855
(906) 226-3576
(906) 226-2380
Mailing address
425 FISHER ST, MARQUETTE, MI 49855-4521
(906) 226-3576
(906) 226-2380
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
52-6160
MI
3336L0003X
Long Term Care Pharmacy
5301005604
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002286
—
MI
01
—
23-5494
MEDICARE PROVIDER #
MI
Enumeration date
01/25/2006
Last updated
08/04/2021
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