Organization
INTERCARE COMMUNITY HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VELMA HENDERSHOTT (PRESIDENT CEO)
(269) 427-7937
Entity
Organization
Contact information
Practice address
6270 W MAIN STREET, EAU CLAIRE, MI 49111
(269) 461-6927
(269) 461-3068
Mailing address
50 INDUSTRIAL PARK DRIVE, BANGOR, MI 49013
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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