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58144 Gratiot Ave New Haven MI 48048 | |
(586) 749-5197 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 58144 Gratiot Ave, New Haven, Michigan |
Authorized Official Name and Position | Michael J Baranowski (CEO) |
Authorized Official Contact | 5867495197 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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555 Saint Clair River Dr Algonac MI 48001-1802 Ph: (810) 794-4982 | 58144 Gratiot Ave New Haven MI 48048 Ph: (586) 749-5197 |
NPI Number | 1750757282 |
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Provider Enumeration Date | 08/19/2015 |
Last Update Date | 03/02/2017 |
Identifier | Type | State | Issuer |
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1750757282 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |