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Organization

COUNTY OF OTTAWA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA STEFANOVSKY (HEALTH OFFICER)
(616) 393-5781
Entity
Organization

Contact information

Practice address
12251 JAMES ST, SUITE 400, HOLLAND, MI 49424-9675
(616) 393-5781
(616) 393-5643
Mailing address
12251 JAMES ST, SUITE 400, HOLLAND, MI 49424-9675
(616) 393-5781
(616) 393-5643

Taxonomy

Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1678299
MI
05
1678314
MI
05
5100813
MI
05
5100822
MI
Enumeration date
10/16/2006
Last updated
08/25/2020
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