Organization
HIAWATHA BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL HARMA (CEO)
(906) 341-2144
Entity
Organization
Contact information
Practice address
3865 S MACKINAC TRL, SAULT SAINTE MARIE, MI 49783-9286
(906) 632-2805
Mailing address
125 N LAKE ST, MANISTIQUE, MI 49854-1234
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M49670
MEDICARE GROUP NUMBER
—
Enumeration date
05/05/2010
Last updated
05/19/2010
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