Organization
CENTER FOR FAMILY HEALTH
Active
Other names
Northeast Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE MAYO (PATIENT ACCOUNTS MANAGER)
(517) 748-5500
Entity
Organization
Contact information
Practice address
1024 FLEMING AVE, JACKSON, MI 49202-2536
(517) 787-4361
(517) 787-4983
Mailing address
PO BOX 548, JACKSON, MI 49204-0548
(517) 784-3950
(517) 796-0003
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
MI
1041S0200X
School Social Worker
—
MI
1223G0001X
General Practice Dentistry
—
MI
124Q00000X
Dental Hygienist
—
MI
207Q00000X
Family Medicine Physician
—
MI
207R00000X
Internal Medicine Physician
—
MI
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500C807070
BCBS GROUP NUMBER
MI
01
—
700C810070
BCBSM GROUP NUMBER
MI
Enumeration date
11/15/2006
Last updated
02/10/2022
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