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Organization
PINECREST MEDICAL CARE FACILITY
Active
Organization
PINECREST MEDICAL CARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA SMITH (ADMINISTRATOR)
(906) 497-5641
Entity
Organization
Contact information
Practice address
N15995 MAIN ST, POWERS, MI 49874-9608
(906) 497-5244
(906) 497-5005
Mailing address
PO BOX 603, POWERS, MI 49874-0603
(906) 497-5244
(906) 497-5005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
314000000X
Skilled Nursing Facility
Primary
558510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09623
BCBSM PROVIDER ID NUMBER
MI
01
—
30413
BCBSM PROVIDER NUMBER
MI
05
—
61 2085277
—
MI
05
—
64 2085277
—
MI
Enumeration date
07/05/2005
Last updated
06/11/2026
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