| NPI | 1982815932 |
|---|---|
| Doing Business As | GREAT LAKES FAMILY CARE |
| 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 | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-11-12 |