Organization
INTERCARE COMMUNITY HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VELMA HENDERSHOTT (PRESIDENT CEO)
(269) 427-7937
Entity
Organization
Contact information
Practice address
800 M-139, BENTON HARBOR, MI 49022
(269) 927-5400
(269) 927-5493
Mailing address
50 INDUSTRIAL PARK DR, BANGOR, MI 49013
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/09/2006
Last updated
11/14/2011
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