Organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Active
Organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Active
Other names
Grand Traverse Band Family Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA ZOTIGH (HEALTH ADMIN)
(231) 534-7241
Entity
Organization
Contact information
Practice address
2300 N STALLMAN RD STE A, SUTTONS BAY, MI 49682-9158
(231) 534-7200
(231) 534-7460
Mailing address
2300 N STALLMAN RD STE A, SUTTONS BAY, MI 49682-9158
(231) 534-7200
(231) 534-7460
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376553586
—
MI
01
—
700D545020
BCBS
MI
Enumeration date
12/15/2006
Last updated
02/11/2025
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