# NORTHERN LIGHT, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851707517
- **Authorized official:** GARY W DAVIS (PRESIDENT)
- **Authorized official phone:** (810) 955-3130

## Contact information

- **Practice address:** 9712 MAPLE ST, RAPID CITY, MI 49676-9213
- **Practice address phone:** (810) 955-3130
- **Practice address fax:** (231) 587-5267
- **Mailing address:** PO BOX 185, RAPID CITY, MI 49676-0185
- **Mailing address phone:** (810) 955-3130
- **Mailing address fax:** (231) 587-5267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | MI | Yes |

## Other

- **Enumeration date:** 07/02/2014
- **Last updated:** 07/02/2014