Organization
CENTER FOR FAMILY HEALTH
Active
Other names
Center for Family Health non FQHC services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE J MAYO (PATIENT ACCOUNT MANAGER)
(517) 748-5500
Entity
Organization
Contact information
Practice address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
(517) 780-9286
Mailing address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
(517) 780-9286
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
364SW0102X
Women's Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D8005290
BCBSM DENTAL GROUP PROV
—
01
—
0M12180
MEDICARE ID TYPE UNSPECIFIED
—
01
—
0N81890
MEDICARE PART B
—
01
—
231865
MEDICARE OSCAR/ CERTIFICATION
—
01
—
500C807070
BCBSM GROUP ID
—
01
—
700C810070
BCBS GROUP
—
Enumeration date
01/05/2012
Last updated
01/05/2012
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