| Little River Band Of Ottawa Indians | |
|
2608 Government Center Dr Manistee MI 49660-8302 | |
| (231) 723-8299 | |
| (231) 398-9684 |
| Full Name | Little River Band Of Ottawa Indians |
|---|---|
| Speciality | Clinic/Center |
| Location | 2608 Government Center Dr, Manistee, Michigan |
| Authorized Official Name and Position | Janice Grant (HEALTH SERVICES SUPERVISOR) |
| Authorized Official Contact | 2317238299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Little River Band Of Ottawa Indians 2608 Government Center Dr Manistee MI 49660-8302 Ph: (231) 723-8299 | Little River Band Of Ottawa Indians 2608 Government Center Dr Manistee MI 49660-8302 Ph: (231) 723-8299 |
| NPI Number | 1154590917 |
|---|---|
| Provider Enumeration Date | 02/26/2008 |
| Last Update Date | 03/22/2016 |
| Medicare PECOS PAC ID | 0547333841 |
|---|---|
| Medicare Enrollment ID | O20080721000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154590917 | NPI | - | NPPES |
| 080E110030 | Other | BCBSMI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 23-1870 (Michigan) | Primary |
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