| Red Pine Run LLC | |
|
5454 County Road 457 Newberry MI 49868-7775 | |
| (906) 869-2961 | |
| Not Available |
| Full Name | Red Pine Run LLC |
|---|---|
| Speciality | Social Worker |
| Location | 5454 County Road 457, Newberry, Michigan |
| Authorized Official Name and Position | Heather Thornton (OWBER) |
| Authorized Official Contact | 9068692961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Pine Run LLC 5454 County Road 457 Newberry MI 49868-7775 | Red Pine Run LLC 5454 County Road 457 Newberry MI 49868-7775 Ph: (906) 869-2961 |
| NPI Number | 1902761018 |
|---|---|
| Provider Enumeration Date | 12/20/2025 |
| Last Update Date | 12/20/2025 |
| Certification Date | 12/20/2025 |
| Medicare PECOS PAC ID | 0446734057 |
|---|---|
| Medicare Enrollment ID | O20260323000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902761018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Heather Thornton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710694328 PECOS PAC ID: 0042660870 Enrollment ID: I20231220001413 |
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