TRAVERSE HEALTH CLINIC AND COALITION NPI 1467632059

NPI Information

NPI: 1467632059
Provider Name: TRAVERSE HEALTH CLINIC AND COALITION

Doing Business As: TRAVERSE HEALTH CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3147 LOGAN VALLEY RD
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 935-0799
Get Directions

TRAVERSE HEALTH CLINIC AND COALITION is a federally qualified health center (fqhc) clinic center in Traverse City, MI. TRAVERSE HEALTH CLINIC AND COALITION NPI is 1467632059. The provider is registered as an organization entity type.
The provider Is Doing Business As Traverse Health Clinic.

The provider's business location address is:

3147 LOGAN VALLEY RD
TRAVERSE CITY, MI
ZIP 49684-772
Phone: (231) 935-0799
Fax: (231) 935-0962

The provider's authorized official is Arlene J. Brennan .
The authorized official title is Ceo and has the following contact phone number (231) 935-0351.

The enumeration date for this NPI number is 11/12/2007 and was last updated on 12/11/2015.

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)			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
1	1841296613	MEDICAID	MICHIGAN
2	1265517494	MEDICAID	MICHIGAN
3	1619196680	MEDICAID	MICHIGAN
4	1972680411	MEDICAID	MICHIGAN
5	1669441457	MEDICAID	MICHIGAN
6	1437155488	MEDICAID	MICHIGAN
7	1891994026	MEDICAID	MICHIGAN
8	1255702486	MEDICAID	MICHIGAN
9	1730153149	MEDICAID	MICHIGAN
10	1760702161	MEDICAID	MICHIGAN

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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