| Region Iv Area Agency On Aging, Inc | |
|
2900 Lakeview Ave Saint Joseph MI 49085-2379 | |
| (269) 983-0177 | |
| Not Available |
| Full Name | Region Iv Area Agency On Aging, Inc |
|---|---|
| Speciality | Nurse Practitioner - Gerontology |
| Location | 2900 Lakeview Ave, Saint Joseph, Michigan |
| Authorized Official Name and Position | Christine Vanlandingham (CEO) |
| Authorized Official Contact | 2699850103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Region Iv Area Agency On Aging, Inc 2900 Lakeview Ave Saint Joseph MI 49085-2379 Ph: () - | Region Iv Area Agency On Aging, Inc 2900 Lakeview Ave Saint Joseph MI 49085-2379 Ph: (269) 983-0177 |
| NPI Number | 1265255327 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265255327 | NPI | - | NPPES |
| 4508944 | Medicaid | MI | |
| 4509342 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LG0600X | Nurse Practitioner - Gerontology | (* (Not Available)) | Primary |
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