Dixie Lodge, LLC
Dixie Lodge, LLC is a healthcare organization registered as Physical Disabilities Residential Treatment Facility in Holly, MI, holding Type 2 (organization) NPI 1962916692 since 2017. The authorized official on file is Margaret Pemberton, Vice President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1962916692 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Dixie Lodge, LLC |
| Other name | <Unavail> |
| Practice address | 10483 DIXIE HWY, Holly, MI, 48442 |
| Phone | 8108664277 |
| Enumeration date | 2017-11-16 |
| Last updated in NPPES | 2023-05-22 |
Authorized official
| Name | Margaret Pemberton |
|---|---|
| Title | Vice President |
| Phone | 5022723466 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 311ZA0620X | Adult Care Home Facility | Secondary | — | — |
| 320700000X | Physical Disabilities Residential Treatment Facility | Primary | — | — |
Copy-ready billing details
Provider: Dixie Lodge, LLC NPI: 1962916692 Taxonomy: 320700000X (Physical Disabilities Residential Treatment Facility) Address: 10483 DIXIE HWY, Holly, MI, 48442
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1730317785 | Level 11 Physical Therapy | Organization | Rehabilitation Clinic/Center | Holly, MI |
| 1952686065 | Amy Selby | Individual | Physical Therapist | Holly, MI |
| 1487075669 | Nicholas Monday | Individual | Physical Therapist | Holly, MI |
| 1003277583 | Abigail Hereau | Individual | Physical Therapist | Holly, MI |
| 1730607896 | Kayla Tubergen | Individual | Occupational Therapist | Holly, MI |
| 1326551201 | Marrissa Tackett | Individual | Recreation Therapist | Holly, MI |
| 1063914646 | Heather Hepper | Individual | Physical Therapist | Holly, MI |
| 1679063267 | Casey Polteraitis | Individual | Speech-Language Pathologist | Holly, MI |
Verify this record
Cross-check NPI 1962916692 against the authoritative CMS record: view Dixie Lodge, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Dixie Lodge, LLC located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-05-22.