Nora Mh | |
24 N Saint Joseph Ave Ste C2 Niles MI 49120-2263 | |
(269) 262-1815 | |
Not Available |
Full Name | Nora Mh |
---|---|
Speciality | Counselor |
Location | 24 N Saint Joseph Ave Ste C2, Niles, Michigan |
Authorized Official Name and Position | Cullen Hardy (OWNER) |
Authorized Official Contact | 2692621815 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Nora Mh 20 N 2nd St Ste 103 Niles MI 49120-2259 Ph: (269) 262-1815 | Nora Mh 24 N Saint Joseph Ave Ste C2 Niles MI 49120-2263 Ph: (269) 262-1815 |
NPI Number | 1134625007 |
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Provider Enumeration Date | 04/01/2018 |
Last Update Date | 02/20/2024 |
Certification Date | 02/20/2024 |
Medicare PECOS PAC ID | 9133567829 |
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Medicare Enrollment ID | O20240401000648 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134625007 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 6401013717 (Michigan) | Primary |
Provider Name | Bridget Green |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1790033231 PECOS PAC ID: 4284072976 Enrollment ID: I20240401000744 |
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