Organization
HACKLEY COMMUNITY CARE CENTER, INC
Active
Other names
Dr. Martin Luther King Academy
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE BLONDIN (CFO)
(231) 733-6657
Entity
Organization
Contact information
Practice address
55 E SHERMAN BLVD, MUSKEGON, MI 49444-1562
(231) 830-3600
Mailing address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629066238
—
MI
Enumeration date
05/21/2021
Last updated
05/21/2021
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