Healthcare Provider Details

I. General information

NPI: 1245283977
Provider Name (Legal Business Name): CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 E PRESTON AVE
MOUNT PLEASANT MI
48858-8990
US

IV. Provider business mailing address

2012 E PRESTON AVE
MOUNT PLEASANT MI
48858-8990
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-5921
  • Fax: 989-773-4319
Mailing address:
  • Phone: 989-773-5921
  • Fax: 989-773-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: STEVEN C HALL
Title or Position: HEALTH OFFICER
Credential:
Phone: 989-773-5921