Healthcare Provider Details

I. General information

NPI: 1578748828
Provider Name (Legal Business Name): MGH FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 OAK AVE
MUSKEGON MI
49442-2408
US

IV. Provider business mailing address

1700 OAK AVE SUITE 011
MUSKEGON MI
49442-2407
US

V. Phone/Fax

Practice location:
  • Phone: 231-773-3828
  • Fax: 231-737-8262
Mailing address:
  • Phone: 231-767-9806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA M LITTLEJOHN
Title or Position: EXECUTIVE DIRECTOR
Credential: M. ED.
Phone: 231-733-4800