Healthcare Provider Details

I. General information

NPI: 1649271636
Provider Name (Legal Business Name): COMMUNITY HEALING CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 STADIUM DR
KALAMAZOO MI
49008-1654
US

IV. Provider business mailing address

2615 STADIUM DR
KALAMAZOO MI
49008-1654
US

V. Phone/Fax

Practice location:
  • Phone: 269-343-1651
  • Fax: 269-382-7078
Mailing address:
  • Phone: 269-343-1651
  • Fax: 269-382-7078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number390172
License Number StateMI

VIII. Authorized Official

Name: MR. MICHAEL C PIOCH
Title or Position: OPERATIONS MANAGER
Credential: BS
Phone: 269-343-1651