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Organization

TRAVERSE HEALTH CLINIC AND COALITION

Active
Parent organization
TRAVERSE HEALTH CLINIC AND COALITION
Other names
Traverse Health Clinic and Coalition Mobile Van #1, Mobile Medical Van
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRAVERSE HEALTH CLINIC AND COALITION
Authorized official
CASEY KANDOW (CEO)
(231) 935-0799
Entity
Organization

Contact information

Practice address
1719 S GARFIELD AVE, TRAVERSE CITY, MI 49686-4337
(231) 935-0799
(231) 935-0962
Mailing address
1719 S GARFIELD AVE, TRAVERSE CITY, MI 49686-4337
(231) 935-0799
(231) 935-0962

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
08/26/2021
Last updated
07/12/2023
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