# MCLAREN CENTRAL MICHIGAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** McLaren Northern Michigan Med Center - Petoskey South
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902419179
- **Authorized official:** TARA SOULES (VP/CFO)
- **Authorized official phone:** (989) 772-6818

## Contact information

- **Practice address:** 1890 US HIGHWAY 131 UNIT 4, PETOSKEY, MI 49770-8344
- **Practice address phone:** (231) 487-2000
- **Mailing address:** 1221 SOUTH DR, MT PLEASANT, MI 48858-3257
- **Mailing address phone:** (989) 772-6700

## Taxonomy

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

## Other

- **Enumeration date:** 08/27/2020
- **Last updated:** 10/21/2021