Organization
NORTHEAST MICHIGAN COMMUNITY MENTAL HEALTH AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES A WHITE (EXECUTIVE DIRECTOR)
(989) 356-2161
Entity
Organization
Contact information
Practice address
400 JOHNSON ST, ALPENA, MI 49707-1434
(989) 356-2161
(989) 354-5898
Mailing address
400 JOHNSON ST, ALPENA, MI 49707-1434
(989) 356-2161
(989) 354-5898
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1708100
—
MI
01
—
26-0-Z4-1060-0
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
—
4352772
—
MI
05
—
4458332
—
MI
Enumeration date
01/06/2007
Last updated
10/02/2008
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