LITTLE RIVER BAND OF OTTAWA INDIANS NPI 1154590917

NPI Information

NPI: 1154590917
Provider Name: LITTLE RIVER BAND OF OTTAWA INDIANS
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
2608 GOVERNMENT CENTER DR
MANISTEE, MI
ZIP 49660
Phone: (231) 723-8299
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LITTLE RIVER BAND OF OTTAWA INDIANS is a federally qualified health center (fqhc) clinic center in Manistee, MI. LITTLE RIVER BAND OF OTTAWA INDIANS NPI is 1154590917. The provider is registered as an organization entity type.

The provider's business location address is:

2608 GOVERNMENT CENTER DR
MANISTEE, MI
ZIP 49660-302
Phone: (231) 723-8299
Fax: (231) 398-9684

The provider's authorized official is Janice Grant .
The authorized official title is Health Services Supervisor and has the following contact phone number (231) 723-8299.

The enumeration date for this NPI number is 2/26/2008 and was last updated on 3/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	23-1870	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080E110030	OTHER		BCBSMI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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