| Hackley Community Care Center Inc | |
| 
					3255 Pontaluna Rd Fruitport MI 49415-9600  | |
| (231) 733-6720 | |
| Not Available | 
| Full Name | Hackley Community Care Center Inc | 
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) | 
| Location | 3255 Pontaluna Rd, Fruitport, Michigan | 
| Authorized Official Name and Position | Danielle Koestner (CMO) | 
| 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: () -  | Hackley Community Care Center Inc 3255 Pontaluna Rd Fruitport MI 49415-9600 Ph: (231) 733-6720  | 
| NPI Number | 1386298552 | 
|---|---|
| Provider Enumeration Date | 07/26/2019 | 
| Last Update Date | 07/26/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1386298552 | NPI | - | NPPES | 
| 1629066238 | Medicaid | MI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary | 
Hackley Community Care Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3113 Pontaluna Rd Ste A, Fruitport, MI 49415 Phone: 231-733-6809  | |
Third Avenue Family Clinic, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 N. Third Ave, Fruitport, MI 49415 Phone: 231-865-3918 Fax: 231-865-3510  | |
X-cell Integrative Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3427 Farr Rd Ste B, Fruitport, MI 49415 Phone: 231-865-7625  | |
W Richard Harris Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4295 Farr Rd, Fruitport, MI 49415 Phone: 231-865-6428  | |
Img Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3427 Farr Rd Ste B, Fruitport, MI 49415 Phone: 231-865-7625  |