Organization
AUSABLE VALLEY CMH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE LIXEY RN (REIMBURSEMENTS SUPERVISOR)
(989) 362-8636
Entity
Organization
Contact information
Practice address
1199 HARRIS AVE, TAWAS CITY, MI 48763-9681
(989) 362-8636
Mailing address
PO BOX 310, TAWAS CITY, MI 48764-0310
(989) 362-8636
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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