# THREE RIVERS HEALTH AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THREE RIVERS HEALTH
- **Other names:** Three Rivers Health Family Care Centreville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508840596
- **Legal business name:** THREE RIVERS HEALTH
- **Authorized official:** WILLIAM RUSSELL (CEO/PRESIDENT)
- **Authorized official phone:** (269) 273-9601

## Contact information

- **Practice address:** 677 E MAIN ST STE B, CENTREVILLE, MI 49032-8525
- **Practice address phone:** (269) 467-9011
- **Practice address fax:** (269) 467-9511
- **Mailing address:** 701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
- **Mailing address phone:** (269) 273-9789
- **Mailing address fax:** (269) 273-9611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 750020 | MI | Yes |

## Other

- **Enumeration date:** 12/02/2005
- **Last updated:** 04/04/2013