| 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 |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2018-08-07 |