Organization
PSYCHNORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JO ANN HADERER RN (OFFICE MANAGER)
(231) 348-5018
Entity
Organization
Contact information
Practice address
2202 MITCHELL PARK DR, STE 5, PETOSKEY, MI 49770-8897
(231) 348-5018
(844) 711-0200
Mailing address
2202 MITCHELL PARK DR, 5, PETOSKEY, MI 49770-8897
(231) 348-5018
(844) 711-0200
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
4301089286
MI
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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