Organization
HACKLEY COMMUNITY CARE CENTER INC
Active
Parent organization
HACKLEY COMMUNITY CARE CENTER INC
Other names
Oakridge Upper Elementary School
Organization subpart
Yes
Provider details
NPI number
Legal business name
HACKLEY COMMUNITY CARE CENTER INC
Authorized official
JO ANN PAPROCKI (BILLING MANAGER)
(231) 733-6804
Entity
Organization
Contact information
Practice address
481 S WOLF LAKE RD STE A, MUSKEGON, MI 49442-3033
(231) 788-7500
Mailing address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629066238
—
MI
Enumeration date
01/17/2018
Last updated
05/11/2018
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