Healthcare Provider Details

I. General information

NPI: 1245145820
Provider Name (Legal Business Name): MICHIGAN RURAL HEALTH CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 RIVERSIDE AVE SUITE 104
ADRIAN MI
49221-1469
US

IV. Provider business mailing address

1643 NW 136TH AVENUE BUILDING H, SUITE 100
SUNRISE FL
33323
US

V. Phone/Fax

Practice location:
  • Phone: 305-519-9897
  • Fax:
Mailing address:
  • Phone: 865-500-1325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES HORST
Title or Position: PRESIDENT
Credential: DO
Phone: 305-519-9897