Provider Demographics
NPI:1306944160
Name:FRIENDSHIP CENTERS OF EMMET COUNTY
Entity type:Organization
Organization Name:FRIENDSHIP CENTERS OF EMMET COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:BERKAU
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:231-347-3211
Mailing Address - Street 1:1322 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-9256
Mailing Address - Country:US
Mailing Address - Phone:231-347-3211
Mailing Address - Fax:231-347-3795
Practice Address - Street 1:1322 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9256
Practice Address - Country:US
Practice Address - Phone:231-347-3211
Practice Address - Fax:231-347-3795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0244026Medicare PIN