| Child And Adolescent Heatlh Center | |
|
96 E 120th St Grant MI 49327-8502 | |
| (231) 834-1350 | |
| (231) 834-1355 |
| Full Name | Child And Adolescent Heatlh Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 96 E 120th St, Grant, Michigan |
| Authorized Official Name and Position | Julie Tatko (CEO) |
| Authorized Official Contact | 2317452743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Child And Adolescent Heatlh Center 1615 Michigan Ave Baldwin MI 49304-7984 Ph: (231) 745-2743 | Child And Adolescent Heatlh Center 96 E 120th St Grant MI 49327-8502 Ph: (231) 834-1350 |
| NPI Number | 1669759437 |
|---|---|
| Provider Enumeration Date | 11/08/2011 |
| Last Update Date | 11/12/2020 |
| Medicare PECOS PAC ID | 1153215413 |
|---|---|
| Medicare Enrollment ID | O20130408000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669759437 | NPI | - | NPPES |
| 0D36000 | Other | BCBS GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
Spectrum Health Gerber Memorial Family Medicine - Grant Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 S Maple St, Grant, MI 49327 Phone: 231-834-5995 Fax: 231-834-0248 | |
Family Health Care Grant Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11 N Maple St, Grant, MI 49327 Phone: 231-834-0444 Fax: 231-834-0200 | |
Grant Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 S Maple, Grant, MI 49327 Phone: 231-834-5995 Fax: 231-834-0248 | |
Gerald Van Wieren, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 71 S Front St, Grant, MI 49327 Phone: 231-834-5676 Fax: 231-834-7211 | |
Spectrum Health Ludington Hospital Family Medicine Grant Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 230 S Maple St, Grant, MI 49327 Phone: 231-834-5995 |