1497027395 NPI number — MCBEAN TRANSITIONAL CARE, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497027395 NPI number — MCBEAN TRANSITIONAL CARE, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCBEAN TRANSITIONAL CARE, LLC.
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:
1497027395
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 113
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SWARTZ CREEK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48473-0113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-877-1814
Provider Business Mailing Address Fax Number:
810-820-6203

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2065 S ELMS RD
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
SWARTZ CREEK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48473-9796
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-877-1814
Provider Business Practice Location Address Fax Number:
810-820-6203
Provider Enumeration Date:
02/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MCBEAN
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
810-877-1814

Provider Taxonomy Codes

  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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