Provider Demographics
NPI:1609098060
Name:HEALTHY FOCUS
Entity type:Organization
Organization Name:HEALTHY FOCUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-755-2223
Mailing Address - Street 1:892 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-3578
Mailing Address - Country:US
Mailing Address - Phone:231-755-2223
Mailing Address - Fax:231-759-8102
Practice Address - Street 1:892 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-3578
Practice Address - Country:US
Practice Address - Phone:231-755-2223
Practice Address - Fax:231-759-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIB1824C251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health