Organization
GREAT LAKES BAY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GALONSKA (VICE PRESIDENT)
(989) 759-6464
Entity
Organization
Contact information
Practice address
501 LAPEER AVE, SAGINAW, MI 48607-1208
(989) 759-6464
(989) 399-8233
Mailing address
501 LAPEER AVE, SAGINAW, MI 48607-1208
(989) 759-6464
(989) 399-8233
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G36111
0G36111 MEEDICARE PAY BILL TO
MI
Enumeration date
08/31/2006
Last updated
09/19/2016
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