Organization
MIDMICHIGAN HEALTH SERVICES
Active
Organization
MIDMICHIGAN HEALTH SERVICES
Active
Other names
MidMichigan Health Park-Houghton Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES P. RASCHKE (EXECUTIVE DIRECTOR)
(989) 422-5122
Entity
Organization
Contact information
Practice address
9249 W LAKE CITY RD, HOUGHTON LAKE, MI 48629-9602
(989) 422-5122
(989) 422-6838
Mailing address
9249 W LAKE CITY RD, HOUGHTON LAKE, MI 48629-9602
(989) 422-5122
(989) 422-4378
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4301068191
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18009
BCBSM FACILITY CODE
MI
Enumeration date
11/04/2005
Last updated
04/22/2015
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