| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 436 W Main St, Hale, Michigan |
| Authorized Official Name and Position | James Balten (PRESIDENT & CEO) |
| Authorized Official Contact | 9896542491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
436 W Main St Hale MI 48739-9246 Ph: (989) 728-2800 | 436 W Main St Hale MI 48739-9246 Ph: (989) 728-2800 |
| NPI Number | 1255712873 |
|---|---|
| Provider Enumeration Date | 06/10/2015 |
| Last Update Date | 02/16/2016 |
| Medicare PECOS PAC ID | 3577560846 |
|---|---|
| Medicare Enrollment ID | O20150923001955 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255712873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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