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General NPI Number Information
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NPI Number | 1962223453
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Entity Type | Organization
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Legal Business Name | BALDWIN FAMILY HEALTH CARE
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 351 N MAIN ST
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City | KENT CITY
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State | MI
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Zip | 49330-9110
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Country | US
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Telephone | 616-678-6002
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Fax |
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Provider Business Mailing Address
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Address Line | 520 COBB ST
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City | CADILLAC
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State | MI
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Zip | 49601-2588
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Country | US
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Telephone | 231-876-6527
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Fax | 231-876-6519
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Authorized Official
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Title or Position | CEO
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Name | JULIE TATKO
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Credential |
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Telephone | 231-745-5482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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