Organization
NORTH COUNTRY COMMUNITY MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALEXIS KACZYNSKI (EXECUTIVE DIRECTOR)
(231) 347-7890
Entity
Organization
Contact information
Practice address
1420 PLAZA DR, PETOSKEY, MI 49770-9420
(231) 439-1233
(231) 347-1241
Mailing address
1420 PLAZA DR, PETOSKEY, MI 49770-9420
(231) 439-1233
(231) 347-1241
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4476072
—
MI
05
—
4476116
—
MI
05
—
4476125
—
MI
Enumeration date
12/19/2006
Last updated
12/16/2015
Update your record
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