Healthcare Provider Details

I. General information

NPI: 1326558065
Provider Name (Legal Business Name): ALCONA CITIZENS FOR HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 10/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SOUTH PLEASANT ST
PICKFORD MI
49774
US

IV. Provider business mailing address

PO BOX 655
ALPENA MI
49707-0655
US

V. Phone/Fax

Practice location:
  • Phone: 906-647-6285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE BAUMGARDNER
Title or Position: CEO
Credential:
Phone: 989-358-0673