HACKLEY COMMUNITY CARE CENTER INC (NPI# 1629066238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629066238 |
| Entity Type | Organization |
| Organization Name | HACKLEY COMMUNITY CARE CENTER INC |
| Practice Address |
2700 Baker St 3rd Floor Muskegon MI 49444-2157 |
| Practice Telephone | 2317371335 |
| Practice Fax Number | 2317370534 |
| Mailing Telephone | 2317371335 |
| Mailing Fax Number | 2317370534 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2010-11-24 |
| Authorized Official Name | WAYNE H KOHN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2317371335 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 1598319915 | Hackley Community Care Center Inc | Clinic/Center | 2312 Denmark St, Muskegon, MI 49441-1479 | 2019-07-25 |
| 1619485398 | Hackley Community Care Center Inc | Family Medicine | 481 S Wolf Lake Rd Ste A, Muskegon, MI 49442-3033 | 2018-01-17 |
| 1962881862 | Hackley Community Care Center Inc | Counselor | 1150 Amity Ave, Muskegon, MI 49442-3713 | 2015-05-26 |
| 1881073781 | Hackley Community Care Center Inc | Counselor | 480 Bennett St, Muskegon, MI 49442-2133 | 2015-05-26 |
| 1699154591 | Hackley Community Care Center Inc | Counselor | 2441 Sanford St, Muskegon, MI 49444-1438 | 2015-05-26 |
| 1063891968 | Hackley Community Care Center Inc | Counselor | 125 Catherine Ave, Muskegon, MI 49442-3331 | 2015-05-26 |
| 1508245408 | Hackley Community Care Center Inc | Counselor | 80 W Southern Ave, Muskegon, MI 49441-2541 | 2015-05-26 |
| Street Address |
2700 BAKER ST 3RD FLOOR |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49444-2157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619476918 | Heather Ann Hoover | Dental Hygienist | 2700 Baker St, Muskegon, MI 49444-2157 | 2018-02-02 |
| 1134641277 | Yessica Escutia Ponce De Leon | Dentist | 2700 Baker St, Muskegon, MI 49444 | 2017-07-11 |
| 1356724702 | Stacey Steeno | Advanced Practice Midwife | 2700 Baker St, Muskegon, MI 49444-2157 | 2015-07-02 |
| 1225364953 | Carmel Elaise Mckentry | Counselor | 2700 Baker St, Muskegon, MI 49444-2157 | 2009-10-31 |
| 1982884383 | Shannon Varela | Pharmacist | 2700 Baker St, Muskegon, MI 49444-2157 | 2007-11-14 |
| 1114107547 | Hackley Community Care Center, Inc | Pharmacy | 2700 Baker St, Muskegon, MI 49444-2157 | 2007-11-14 |
| 1720098551 | Virendra K Das | Family Medicine | 2700 Baker St, 3rd Floor, Muskegon, MI 49444-2157 | 2006-08-08 |
| 1124042445 | Suzanne E Carl | Registered Nurse | 2700 Baker St, 3rd Floor, Muskegon, MI 49444-2157 | 2006-07-27 |
| 1558385849 | Tawna W Vallance | Physician Assistant | 2700 Baker St, 3rd Floor, Muskegon, MI 49444-2157 | 2006-07-27 |
| 1215950605 | Kelly S Briden | Family Medicine | 2700 Baker St, 3rd Floor, Muskegon, MI 49444-2157 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073084349 | Cathy Forrest, Ma, LLP Plc | Psychologist | 255 Seminole Road, Suite-205, Muskegon, MI 49444 | 2018-12-16 |
| 1831687276 | Sarah J Weiden | Massage Therapist | 1040 E Sternberg Rd, Muskegon, MI 49444 | 2018-04-30 |
| 1184131500 | Hatem M Gelani Sr. | Dentist | 1725 E Sherman Blvd, Muskegon, MI 49444 | 2018-01-08 |
| 1497123673 | Rite Aid | Pharmacist | 2213 E Hile Road, Muskegon, MI 49444 | 2015-09-04 |
| 1689077075 | Rosa Carpenter-parker | Counselor | 445 East Sherman, Muskegon, MI 49444 | 2014-09-30 |
| 1417373036 | Smile Center Pllc | Dentist | 3500 Park Street, Smile Center Pllc, Muskegon, MI 49444 | 2014-03-06 |
| 1134460439 | Adam L Powell | Physical Medicine & Rehabilitation | 1675 E Mount Garfield Rd, Muskegon, MI 49444 | 2013-03-12 |
| 1972847135 | Kristen Haugh | Physical Therapist | 5251 Harvey St Ste 100, Norton Shores, MI 49444 | 2012-11-12 |
| 1912261694 | Brandon D Freel | Obstetrics & Gynecology | 6401 Prairie St Ste 2100, Norton Shores, MI 49444 | 2012-06-27 |
| 1437434487 | Amy Stegall | Pharmacist | 1171 E Sherman, Norton Shores, MI 49444 | 2011-10-20 |
| Find all providers in zip 49444 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1598319915 | Hackley Community Care Center Inc | Clinic/Center | 2312 Denmark St, Muskegon, MI 49441-1479 | 2019-07-25 |
| 1255331583 | Mgh Family Health Center | Clinic/Center | 2201 S Getty St, Muskegon, MI 49444-1207 | 2005-07-28 |
| 1912506635 | Hackley Community Care Center Inc | Clinic/Center | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2020-10-23 |
| 1194379172 | Hackley Community Care Center Inc | Clinic/Center | 35 S Sheridan Dr, Muskegon, MI 49442-1440 | 2019-07-29 |
| 1346600905 | Cherry Street Services Inc | Clinic/Center | 1611 Oak Ave, Muskegon, MI 49442-2468 | 2016-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1831706993 | Family Medical Center of Michigan, Inc | Clinic/Center | 503 Washington St Rm 150, Monroe, MI 48161-1309 | 2020-09-23 |
| 1326654666 | Family Medical Center of Michigan,inc | Clinic/Center | 550 E Main St Ste 1001, Hudson, MI 49247-9535 | 2020-09-22 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 1700400389 | Northwest Michigan Health Services, Inc. | Clinic/Center | 300 W Broadway Ave Trlr 1, Scottville, MI 49454-1019 | 2020-05-30 |
| 1679195721 | Family Medical Center of Michigan,inc | Clinic/Center | 2740 Collingwood St Ste 100, Detroit, MI 48206-1473 | 2020-05-12 |
| 1235750571 | Great Lakes Bay Health Centers | Clinic/Center | 2300 Veterans Memorial Pkwy, Saginaw, MI 48601-1268 | 2020-04-28 |
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1568096923 | Grace Health, Inc. | Clinic/Center | 825 Capital Ave Ne, Battle Creek, MI 49017-5605 | 2020-02-25 |
| 1336779131 | Northwest Michigan Health Services Inc. | Clinic/Center | 512 Bryant Ave., Room 23, Manistee, MI 49660-1839 | 2020-01-21 |
| Find all providers with the same taxonomy | ||||
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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.