# SPECTRUM HEALTH KELSEY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeview Youth Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730466822
- **Authorized official:** DAVID J OEHRING (VICE PRESIDENT FINANCE)
- **Authorized official phone:** (616) 225-6411

## Contact information

- **Practice address:** 420 S LINCOLN ST, LAKEVIEW, MI 48850-8500
- **Practice address phone:** (989) 352-1800
- **Mailing address:** 418 WASHINGTON ST, LAKEVIEW, MI 48850-9806
- **Mailing address phone:** (989) 352-6435
- **Mailing address fax:** (989) 352-8451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2011
- **Last updated:** 11/03/2011