UPPER GREAT LAKES FAMILY HEALTH CENTER (NPI# 1740603885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740603885 |
Entity Type | Organization |
Organization Name | UPPER GREAT LAKES FAMILY HEALTH CENTER |
Other Organization Name | LAKE LINDEN FAMILY HEALTH CENTER |
Practice Address |
945 Ninth Street Lake Linden MI 49945-1100 |
Mailing Address |
506 Campus Drive Hancock MI 49930-1569 |
Practice Telephone | 9064831030 |
Practice Fax Number | 9064831270 |
Mailing Telephone | 9864831705 |
Mailing Fax Number | 9064831394 |
Enumeration Date | 2014-01-25 |
Last Update Date | 2016-04-18 |
Authorized Official Name | DONALD A SIMILA (CEO) |
Authorized Official Telephone | 9064831325 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MI | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Lake Linden Family Health Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
1659889673 | Upper Great Lakes Family Health Center | Psychiatry & Neurology | 965 Fee Rd Rm A229, East Lansing, MI 48824-6410 | 2018-01-11 |
1336563832 | Upper Great Lakes Family Health Center | Clinic/Center | 751 S 7th Street, Ontonagon, MI 49953-1450 | 2014-02-05 |
1508289273 | Upper Great Lakes Family Health Center | Clinic/Center | 1500 W Ice Lake Road, Iron River, MI 49935-8509 | 2014-01-30 |
1811325103 | Upper Great Lakes Family Health Center | Clinic/Center | 600 Macinnes Drive, Houghton, MI 49931-1144 | 2013-10-23 |
1700103777 | Upper Great Lakes Family Health Center | Family Medicine | 301 Explorer Street, Gwinn, MI 49841-2813 | 2010-04-29 |
1104158690 | Upper Great Lakes Family Health Center | Family Medicine | 135 East M 35, Gwinn, MI 49841-9159 | 2010-02-08 |
1396295721 | Upper Great Lakes Family Health Center | Dentist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2016-10-10 |
1164893491 | Upper Great Lakes Family Health Center | Dentist | 301 Explorer St, Gwinn, MI 49841-2813 | 2015-10-13 |
1205217239 | Upper Great Lakes Family Health Center | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2015-06-16 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | UPPER GREAT LAKES FAMILY HEALTH CENTER | 506 Campus Dr, Hancock, MI 49930-1569 |
Street Address |
945 NINTH STREET |
City | LAKE LINDEN |
State | MI |
Zip Code | 49945-1100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689037475 | Morgan Nicole Codere | Specialist/Technologist | 1200 Calumet St, Lake Linden, MI 49945 | 2016-03-30 |
1750495727 | Aspirus Keweenaw Enterprise | Pharmacy | 220 Calumet St, Lake Linden, MI 49945 | 2006-08-18 |
1811919251 | Thomas Mcconnon | Emergency Medicine | 945 9th St, Lake Linden, MI 49945-1100 | 2006-07-24 |
1003475344 | Jenny M Bausano | Nurse Practitioner | 945 9th St, Lake Linden, MI 49945-1100 | 2019-06-11 |
1154758167 | Portage Physician Practices Inc | Clinic/Center | 945 9th St, Lake Linden, MI 49945-1100 | 2013-10-04 |
1386970481 | Portage Health Inc. | Family Medicine | 945 9th St, Lake Linden, MI 49945-1100 | 2009-10-23 |
1033413612 | Pieter Nieuwenhuis | Physical Therapist | 1310 Front St, Lake Linden, MI 49945-1220 | 2010-12-22 |
1538552005 | At Home Companions, Inc. | Home Health | 1150 Garden St, Lake Linden, MI 49945-1292 | 2015-03-09 |
1649320524 | Aspirus Keweenaw | Clinic/Center | 110 Calumet Street, Lake Linden, MI 49945-1308 | 2007-01-11 |
1356537310 | Bruce Robert Macdonald | Dentist | 207 Calumet St, Lake Linden, MI 49945-1309 | 2007-09-23 |
Find all providers in zip 49945 |
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 |
---|---|---|---|---|
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 |
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 |
Find all providers with the same taxonomy |
City | LAKE LINDEN |
Zip Code | 49945 |
Please comment or provide details below to improve the information on UPPER GREAT LAKES FAMILY HEALTH CENTER.
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.