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HIAWATHA COMMUNITY BEHAVIORAL HEALTH AUTHORITY NPI 1629161567


NPI Information

NPI: 1629161567
Provider Name: HIAWATHA COMMUNITY BEHAVIORAL HEALTH AUTHORITY

Doing Business As: HIAWATHA BEHAVIORAL HEALTH

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
3865 S MACKINAC TRL
SAULT SAINTE MARIE, MI
ZIP 49783
Phone: (906) 632-2805
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HIAWATHA COMMUNITY BEHAVIORAL HEALTH AUTHORITY is a community behavioral health in Sault Sainte Marie, MI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. HIAWATHA COMMUNITY BEHAVIORAL HEALTH AUTHORITY NPI is 1629161567. The provider is registered as an organization entity type.
The provider Is Doing Business As Hiawatha Behavioral Health.

The provider's business location address is:

3865 S MACKINAC TRL
SAULT SAINTE MARIE, MI
ZIP 49783-286
Phone: (906) 632-2805
Fax: (906) 632-1163

The provider's authorized official is Samuel Harma .
The authorized official title is Chief Executive Officer and has the following contact phone number (906) 341-2144.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 11/16/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10M49630MEDICARE ID-TYPE UNSPECIFIEDMICHIGANGROUP NUMBER/SOCIAL WORK
20M49670MEDICARE ID-TYPE UNSPECIFIEDMICHIGANGROUP NUMBER/PSYCHIATRY
37509104110OTHERMICHIGANBCBS
4774361332MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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