Organization
CENTER FOR FAMILY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE MAYO (PATIENT ACCOUNTS MANAGER)
(517) 748-5500
Entity
Organization
Contact information
Practice address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
(517) 783-2728
Mailing address
505 N JACKSON ST, JACKSON, MI 49201-1266
(517) 748-5500
(517) 783-2728
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
MI
1223G0001X
General Practice Dentistry
—
MI
124Q00000X
Dental Hygienist
—
MI
126800000X
Dental Assistant
—
MI
207Q00000X
Family Medicine Physician
—
MI
207R00000X
Internal Medicine Physician
—
MI
207V00000X
Obstetrics & Gynecology Physician
—
MI
208000000X
Pediatrics Physician
—
MI
261QC1500X
Community Health Clinic/Center
—
MI
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
MI
363LA2200X
Adult Health Nurse Practitioner
—
MI
363LF0000X
Family Nurse Practitioner
—
MI
363LP0200X
Pediatric Nurse Practitioner
—
MI
364SW0102X
Women's Health Clinical Nurse Specialist
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D8005290
BCBSM DENTAL GROUP PROV
MI
01
—
500C807070
BCBSM GROUP ID
MI
01
—
700C810070
BCBSM GROUP NUMBER
MI
Enumeration date
09/23/2006
Last updated
02/10/2022
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