| NPI | 1790067338 |
|---|---|
| Other Name | CHILD AND ADOLESCENT HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JULIE TATKO CEO 231-745-2743 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2020-11-12 |