| East Jordan Family Health Center | |
|
7960 W. Old State Road Central Lake MI 49622 | |
| (231) 544-3700 | |
| Not Available |
| Full Name | East Jordan Family Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 7960 W. Old State Road, Central Lake, Michigan |
| Authorized Official Name and Position | Diane Hawley (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2315362206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Jordan Family Health Center 7960 W. Old State Road Central Lake MI 49622 Ph: (231) 544-3700 | East Jordan Family Health Center 7960 W. Old State Road Central Lake MI 49622 Ph: (231) 544-3700 |
| NPI Number | 1669680187 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 08/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669680187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Secret Forest Country Doctor Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 493 N Derenzy Rd, Central Lake, MI 49622 Phone: 231-544-7001 Fax: 231-600-7054 |