Organization
BALDWIN FAMILY HEALTH CARE
Active
Parent organization
BALDWIN FAMILY HEALTH CARE
Other names
Child and Adolescent Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BALDWIN FAMILY HEALTH CARE
Authorized official
JULIE TATKO (CEO)
(231) 745-2743
Entity
Organization
Contact information
Practice address
525 4TH ST, BALDWIN, MI 49304
(231) 745-3116
(231) 745-3136
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-5045
(231) 745-5031
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D36000
BLUE CROSS GROUP
—
01
—
BPS-H80-001144
FQHC SITE ID
—
Enumeration date
04/26/2007
Last updated
11/12/2020
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