NPI | 1235750571 |
---|---|
Doing Business As | GREAT LAKES BAY HEALTH CENTERS TRI-CAP |
Entity Type | Organization |
Authorized Contact | DAWN CHRISTIAN Provider Enrollment 989-759-6464 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-04-28 |
Last Update Date | 2021-09-14 |