Organization
HIAWATHA COMMUNITY BEHAVIORAL HEALTH AUTHORITY
Active
Other names
HIAWATHA BEHAVIORAL HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL HARMA (CHIEF EXECUTIVE OFFICER)
(906) 341-2144
Entity
Organization
Contact information
Practice address
3865 S MACKINAC TRL, SAULT SAINTE MARIE, MI 49783-9286
(906) 632-2805
(906) 632-1163
Mailing address
125 N LAKE ST, MANISTIQUE, MI 49854-1234
(906) 341-2144
(906) 341-5793
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7509104110
BCBS
MI
05
—
774361332
—
MI
Enumeration date
10/02/2006
Last updated
11/16/2011
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