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Organization

BALDWIN FAMILY HEALTH CARE

Active
Parent organization
BALDWIN FAMILY HEALTH CARE
Other names
Child and Adolescent Heatlh Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
BALDWIN FAMILY HEALTH CARE
Authorized official
JULIE TATKO (CEO)
(231) 745-2743
Entity
Organization

Contact information

Practice address
96 E 120TH ST, GRANT, MI 49327-8502
(231) 834-1350
(231) 834-1355
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-2743
(231) 745-3690

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
261QS1000X
Student Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0D36000
BCBS GROUP
Enumeration date
11/08/2011
Last updated
11/12/2020
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