Organization
CHIPPEWA COUNTY HEALTH DEPARTMENT
Active
Other names
Sault High Adolescent Care Center (SHACC)
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE SENKUS (HEALTH OFFICER)
(906) 253-3103
Entity
Organization
Contact information
Practice address
904 MARQUETTE AVE, ROOM 622, SAULT SAINTE MARIE, MI 49783-3301
(906) 632-5690
(906) 635-1325
Mailing address
508 ASHMUN ST STE 120, SAULT SAINTE MARIE, MI 49783-1976
(906) 635-1568
(906) 253-1466
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
6301008585
MI
261QP2300X
Primary Care Clinic/Center
4301030101
MI
261QS1000X
Student Health Clinic/Center
Primary
4301030101
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4904983
—
MI
05
—
4904992
—
MI
05
—
4905004
—
MI
05
—
4905013
—
MI
01
—
500A710530
BCBS-NP GROUP
MI
01
—
680A710440
BCBS-MENTAL HEALTH
MI
Enumeration date
04/06/2007
Last updated
02/26/2021
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