Basic Information
| Provider Information | |||||||||
| NPI: | 1932852746 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MH HEALTH CARE SERVICES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 WINOOSKI FALLS WAY STE 400 | ||||||||
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| City: | WINOOSKI | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054042239 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1485 SUNRISE DR | ||||||||
| Address2: | |||||||||
| City: | ARTHUR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 619111684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664343255 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2022 | ||||||||
| LastUpdateDate: | 02/25/2022 | ||||||||
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| AuthorizedOfficialLastName: | LAYMAN | ||||||||
| AuthorizedOfficialFirstName: | TERRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8664343255 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MARATHON HEALTH, LLC | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| NPICertificationDate: | 02/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.