Organization
INTERCARE COMMUNITY HEALTH NETWORK
Active
Other names
InterCare Child and Adolescent Behavioral Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
VELMA HENDERSHOTT (CEO/PRESIDENT)
(269) 427-7937
Entity
Organization
Contact information
Practice address
7450 HOCHBERGER RD RM 15A, EAU CLAIRE, MI 49111-9762
(269) 461-6947
Mailing address
50 INDUSTRIAL PARK RD, BANGOR, MI 49013-1246
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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