Organization
INTERCARE COMMUNITY HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA MOONEYHAN (CREDENTIALING & ENROLLMENT COORDINA)
(269) 427-7937
Entity
Organization
Contact information
Practice address
538 WASHINGTON STREET ROOM #158, OTSEGO, MI 49078
(855) 866-6900
(269) 427-5180
Mailing address
50 INDUSTRIAL PARK RD, BANGOR, MI 49013-1246
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
12/12/2025
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