| Hackley Community Care Center Inc | |
|
2700 Baker St Fl 3 Muskegon MI 49444-2157 | |
| (231) 737-1335 | |
| (231) 737-0534 |
| Full Name | Hackley Community Care Center Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2700 Baker St Fl 3, Muskegon, Michigan |
| Authorized Official Name and Position | Wayne Kohn (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2317371335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hackley Community Care Center Inc 2700 Baker St Fl 3 Muskegon MI 49444-2157 Ph: (231) 737-1335 | Hackley Community Care Center Inc 2700 Baker St Fl 3 Muskegon MI 49444-2157 Ph: (231) 737-1335 |
| NPI Number | 1255669818 |
|---|---|
| Provider Enumeration Date | 11/19/2009 |
| Last Update Date | 06/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255669818 | NPI | - | NPPES |
| 1629066238 | Other | MI | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Michigan) | Primary |
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