1457286403 NPI number — COUNTY OF NEWAYGO

Table of content: RASHEEDA JACKSON (NPI 1760304851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457286403 NPI number — COUNTY OF NEWAYGO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF NEWAYGO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457286403
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
93 S. GIBBS STREET, PO BOX 885
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE CLOUD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-689-7363
Provider Business Mailing Address Fax Number:
231-689-0871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
93 S. GIBBS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE CLOUD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-689-2100
Provider Business Practice Location Address Fax Number:
231-689-0871
Provider Enumeration Date:
06/12/2026

Additional Information

Authorized Official

Authorized Official Last Name:
WREN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNTY ADMINISTRATOR
Authorized Official Telephone Number:
231-689-7203

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 347E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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