| NPI | 1831866821 |
|---|---|
| Doing Business As | MOBILE MEDICAL VAN |
| Other Name | TRAVERSE HEALTH CLINIC AND COALITION MOBILE VAN #1 |
| Entity Type | Organization |
| Authorized Contact | CASEY KANDOW CEO 231-935-0799 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2023-07-12 |