Healthcare Provider Details

I. General information

NPI: 1164970307
Provider Name (Legal Business Name): AHC-OTTAWA ELEMENTARY SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 KALAMAZOO AVE
PETOSKEY MI
49770-3216
US

IV. Provider business mailing address

1035 W WASHINGTON AVE
ALPENA MI
49707-2929
US

V. Phone/Fax

Practice location:
  • Phone: 231-348-2130
  • Fax: 231-348-2302
Mailing address:
  • Phone: 231-348-2130
  • Fax: 231-348-2302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: NANCY LEE SPENCER
Title or Position: CEO
Credential:
Phone: 989-358-3916