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Organization

BAY MILLS INDIAN COMMUNITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUDREY BREAKIE (HEALTH DIRECTOR)
(906) 248-8327
Entity
Organization

Contact information

Practice address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9319
(906) 248-5527
(906) 248-5765
Mailing address
12455 W LAKESHORE DR, BRIMLEY, MI 49715-9319
(906) 248-5527
(906) 248-5765

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
231839
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053592089
MI
Enumeration date
11/19/2007
Last updated
06/09/2022
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