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General NPI Number Information
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NPI Number | 1154744597
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Entity Type | Organization
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Legal Business Name | HOLY FAMILY HEALTHCARE
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 301 N CENTER ST
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City | HARTFORD
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State | MI
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Zip | 49057-1199
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Country | US
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Telephone | 269-621-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N CENTER ST
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City | HARTFORD
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State | MI
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Zip | 49057-1199
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Country | US
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Telephone | 269-621-0011
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DON D BOUCHARD
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Credential | D.O.
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Telephone | 269-279-9332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801094934
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 6801094934
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601002054
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5101011443
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License Number State | MI
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