Organization
HACKLEY COMMUNITY CARE CENTER INC
Active
Other names
Marquette Elementary
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE KOHN DO (CMO)
(231) 737-1335
Entity
Organization
Contact information
Practice address
550 W GRAND AVE, MUSKEGON, MI 49441-2336
(231) 733-6702
Mailing address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
(231) 737-1335
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/26/2015
Last updated
09/11/2023
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