# STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE OF MICHIGAN
- **Other names:** D.J. Jacobetti Home for Veterans
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285604819
- **Legal business name:** STATE OF MICHIGAN
- **Authorized official:** RONALD OJA (ADMINISTRATOR)
- **Authorized official phone:** (906) 226-3576

## Contact information

- **Practice address:** 425 FISHER ST, MARQUETTE, MI 49855
- **Practice address phone:** (906) 226-3576
- **Practice address fax:** (906) 226-2380
- **Mailing address:** 425 FISHER ST, MARQUETTE, MI 49855-4521
- **Mailing address phone:** (906) 226-3576
- **Mailing address fax:** (906) 226-2380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 52-6160 | MI | Yes |
| 3336L0003X | Long Term Care Pharmacy | 5301005604 | MI | — |

## Other

- **Enumeration date:** 01/25/2006
- **Last updated:** 08/04/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002286 | — | MI |
| 01 | — | 23-5494 | MEDICARE PROVIDER \# | MI |