NPI | 1912265547 |
---|---|
Doing Business As | GREAT LAKES BAY HEALTH CENTERS SHIAWASSEE |
Entity Type | Organization |
Authorized Contact | LISA M GALSONSKA Interum President 989-759-6448 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2012-05-02 |
Last Update Date | 2018-08-07 |