Organization
GREATER OAKLAND VISITING NURSE ASSOCIATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA M FISHMAN M.S.N., M.S.B.A. (CHIEF EXECUTIVE OFFICER)
(248) 683-1770
Entity
Organization
Contact information
Practice address
959 W HURON ST, WATERFORD, MI 48328-3727
(248) 683-1770
(248) 683-1774
Mailing address
959 W HURON ST, WATERFORD, MI 48328-3727
(248) 683-1770
(248) 683-1774
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
237013
MI
251V00000X
Voluntary or Charitable Agency
237013
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004857
CAPE INSURRANCE
MI
01
—
0E027
BLUE CROSS PROVIDER NO.
MI
01
—
125910
GREAT LAKES HLTH PROVID.
MI
05
—
5173856
—
MI
01
—
M017039
CHAMPUS PROVIDER NO.
MI
Enumeration date
07/05/2006
Last updated
06/09/2010
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