Organization
IOSCO MEDICAL CARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON R. LOOK NHA (ADMINISTRATOR)
(989) 362-4424
Entity
Organization
Contact information
Practice address
1201 HARRIS AVE, TAWAS CITY, MI 48763-9680
(989) 362-4424
(989) 362-4904
Mailing address
1201 HARRIS AVE, TAWAS CITY, MI 48763-9680
(989) 362-4424
(989) 362-4904
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
414350
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2085508
—
MI
05
—
4975303
—
MI
Enumeration date
10/11/2005
Last updated
05/15/2013
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