MANISTEE BENZIE COMMUNITY MENTAL HEALTH (NPI# 1366806432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366806432 |
| Entity Type | Organization |
| Organization Name | MANISTEE BENZIE COMMUNITY MENTAL HEALTH |
| Other Organization Name | CENTRA WELLNESS NETWORK |
| Practice Address |
310 Glocheski Dr Manistee MI 49660-2639 |
| Practice Telephone | 2313091719 |
| Practice Fax Number | 2317231504 |
| Mailing Telephone | 2313091719 |
| Mailing Fax Number | 2317231504 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2020-02-05 |
| Authorized Official Name | MS. DONNA J NIEMAN (CHIEF FINANCE OFFICER) |
| Authorized Official Telephone | 2313091719 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Centra Wellness Network | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699814905 | Manistee Benzie Community Mental Health | Community/Behavioral Health | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2007-02-05 |
| 1063581205 | Manistee Benzie Community Mental Health | Community/Behavioral Health | 395 3rd St, Manistee, MI 49660-1718 | 2006-11-06 |
| Street Address |
310 GLOCHESKI DR |
| City | MANISTEE |
| State | MI |
| Zip Code | 49660-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437230596 | Thomas Zatolokin | Psychiatry & Neurology | 310 Glocheski Dr, Manistee, MI 49660-0335 | 2006-10-17 |
| 1275011520 | Jo'dee Fisk | Social Worker | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2018-07-30 |
| 1467971606 | Carl Jaskiw | Behavior Technician | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2017-09-19 |
| 1386183226 | William Ward | Community Health Worker | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2017-02-13 |
| 1275072183 | Connie Jankwietz | Community Health Worker | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2017-02-13 |
| 1437697604 | Ann E Morehouse | Registered Nurse | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2017-02-07 |
| 1568910446 | Jessica Derosia | Community Health Worker | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2016-09-20 |
| 1801344700 | Sonya Broadbent | Social Worker | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2016-09-20 |
| 1699221358 | Mark Anthony Pettinato | Counselor | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2016-08-31 |
| 1154741122 | Joy Pomeroy | Registered Nurse | 310 Glocheski Dr, Manistee, MI 49660-2639 | 2014-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083192306 | Margaret R Batzer | Acupuncturist | 352 1st St, Manistee, MI 49660 | 2018-07-30 |
| 1821590373 | Esther Sigurdardottir | Physical Therapist | 1465 E. Parkdale Av, Manistee, MI 49660 | 2018-03-01 |
| 1104328657 | Bryan Keith Kidd | Physical Therapist | 1465 Parkdale Avenue, Manistee, MI 49660 | 2018-03-01 |
| 1790153799 | Deborah Ann Brandt | Registered Nurse | 318 River Street, Friends Who Care, Manistee, MI 49660 | 2015-09-08 |
| 1265811624 | Joyce Eileen Copeland | Assisted Living Facility | 3644 Chippewa Hwy, Manistee, MI 49660 | 2015-05-19 |
| 1275927931 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 16 Caberfae Hwy, Manistee, MI 49660 | 2015-03-20 |
| 1518244912 | Mara Lane Mckinley | Nurse Practitioner | 1465 E. Parkdale Ave3., Manistee, MICHIGAN 49660 | 2011-11-14 |
| 1477749406 | Catherine Imelda Oertel | Social Worker | 2198 Us 31 South, Manistee, MI 49660 | 2007-09-24 |
| 1811109051 | Goodwill Optical Inc | Optometrist | 282 12th St, Manistee, MI 49660 | 2007-05-03 |
| 1144364381 | Layne Christopher Godzina | Dentist | 422 First Street, Manistee, MI 49660 | 2007-02-19 |
| Find all providers in zip 49660 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1487252458 | Midland Express Urgent and Family Care | Clinic/Center | 600 Cambridge St Ste 1, Midland, MI 48642-4508 | 2020-10-13 |
| 1841805306 | Alex Wagner, LLC | Clinic/Center | 1864 Lakeshore Dr Ste A, Muskegon, MI 49441-1607 | 2020-09-11 |
| 1760013262 | Tranquility Wellness Center | Clinic/Center | 5237 Oakman Blvd Ste B100, Dearborn, MI 48126-4045 | 2020-02-03 |
| 1588295463 | Scheurer Hospital | Clinic/Center | 100 Pigeon Rd Ste C, Bad Axe, MI 48413-8169 | 2020-01-30 |
| 1639718539 | Scheurer Hospital | Clinic/Center | 75 Buschlen Rd, Bad Axe, MI 48413 | 2019-12-26 |
| 1780235465 | Careatc | Clinic/Center | 2221 Health Dr Sw Ste 1500, Grand Rapids, MI 49519-9681 | 2019-09-24 |
| 1821649948 | Hope Primary Care of Birch Run Pllc | Clinic/Center | 9143 Birh Run Rd, Ste 3, Birch Run, MI 48415 | 2019-09-20 |
| 1609425180 | Wafa A Elhassan Md Pllc | Clinic/Center | 1905 S Haggerty Rd, Canton, MI 48188-2025 | 2019-09-08 |
| 1861966244 | Progressive Care Medical Group of Mi, Pllc | Clinic/Center | 734 Starkweather Drive, Lansing, MI 48917-1128 | 2019-01-18 |
| 1972006047 | Genise Kerner Md PC | Clinic/Center | 37675 Pembrooke Ave, Livonia, MI 48152 | 2018-03-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.