Organization
CENTER FOR FAMILY HEALTH
Active
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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