Healthcare Provider Details

I. General information

NPI: 1649643792
Provider Name (Legal Business Name): CAREHERE MANAGEMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 KENDALL ST S
BATTLE CREEK MI
49037-8471
US

IV. Provider business mailing address

150 KENDALL ST S
BATTLE CREEK MI
49037-8471
US

V. Phone/Fax

Practice location:
  • Phone: 269-441-4141
  • Fax: 269-441-4142
Mailing address:
  • Phone: 269-441-4141
  • Fax: 269-441-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERNIE CLEVENGER
Title or Position: PRESIDENT
Credential:
Phone: 269-441-4141