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Organization

LAKESTATE INDUSTRIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHERYL GERISE OHMAN (EXECUTIVE DIRECTOR)
(906) 786-9212
Entity
Organization

Contact information

Practice address
1830 N 21ST ST, ESCANABA, MI 49829-9586
(906) 786-9212
Mailing address
PO BOX 279, ESCANABA, MI 49829-0279
(906) 786-9212
(906) 789-6004

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Enumeration date
11/13/2019
Last updated
11/13/2019
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