Organization
MYCARE HEALTH CENTER
Active
Organization
MYCARE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN WOOD (CEO)
(586) 619-9986
Entity
Organization
Contact information
Practice address
18 MARKET STREET, SUITE C, MOUNT CLEMENS, MI 48043
(586) 783-2222
(586) 783-6944
Mailing address
6800 E 10 MILE RD, CENTER LINE, MI 48015-1167
(586) 619-9986
(586) 806-5085
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
MI
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080E031630
BCBS GROUP
MI
01
—
0E03765
BC NP GROUP PIN
MI
05
—
1265749683
—
MI
Enumeration date
09/07/2010
Last updated
07/07/2020
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