Organization
HACKLEY COMMUNITY CARE CENTER, INC
Active
Other names
Hackley Community Care - Forest
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE BLONDIN (CHIEF FINANCIAL OFFICER)
(231) 733-6657
Entity
Organization
Contact information
Practice address
172 E FOREST AVE, MUSKEGON, MI 49442-5541
(231) 737-1335
Mailing address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629066238
—
MI
Enumeration date
06/06/2022
Last updated
06/06/2022
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