HACKLEY COMMUNITY CARE CENTER INC (NPI# 1194379172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194379172 |
| Entity Type | Organization |
| Organization Name | HACKLEY COMMUNITY CARE CENTER INC |
| Other Organization Name | ORCHARD VIEW MIDDLE SCHOOL |
| Practice Address |
35 S Sheridan Dr Muskegon MI 49442-1440 |
| Mailing Address |
2700 Baker St Fl 3 Muskegon MI 49444-2157 |
| Practice Telephone | 2317336790 |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2019-07-31 |
| Authorized Official Name | DANIELLE KOESTNER (CMO) |
| Authorized Official Telephone | 2317371335 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Orchard View Middle School | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 1598319915 | Hackley Community Care Center Inc | Clinic/Center | 2312 Denmark St, Muskegon, MI 49441-1479 | 2019-07-25 |
| 1619485398 | Hackley Community Care Center Inc | Family Medicine | 481 S Wolf Lake Rd Ste A, Muskegon, MI 49442-3033 | 2018-01-17 |
| 1962881862 | Hackley Community Care Center Inc | Counselor | 1150 Amity Ave, Muskegon, MI 49442-3713 | 2015-05-26 |
| 1881073781 | Hackley Community Care Center Inc | Counselor | 480 Bennett St, Muskegon, MI 49442-2133 | 2015-05-26 |
| 1699154591 | Hackley Community Care Center Inc | Counselor | 2441 Sanford St, Muskegon, MI 49444-1438 | 2015-05-26 |
| 1063891968 | Hackley Community Care Center Inc | Counselor | 125 Catherine Ave, Muskegon, MI 49442-3331 | 2015-05-26 |
| 1508245408 | Hackley Community Care Center Inc | Counselor | 80 W Southern Ave, Muskegon, MI 49441-2541 | 2015-05-26 |
| Street Address |
35 S SHERIDAN DR |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49442-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104352244 | Jessica Lee Bailey-yabani | Counselor | 35 S Sheridan Dr, Muskegon, MI 49442 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205472321 | Beacon of Light Counseling LLC | Social Worker | 1515 E Laketon Ave, Muskegon, MI 49442 | 2019-11-24 |
| 1528524410 | Tyler Companion | Social Worker | 710 Mclaughlin, Muskegon, MI 49442 | 2019-02-15 |
| 1427549658 | Amber Renee Davidson | Behavioral Analyst | 1175 Wesley Street, Muskegon, MI 49442 | 2018-05-23 |
| 1528559085 | Katherine Dale Kirby | Obstetrics & Gynecology | Mercy Health Hackley, 1700 Clinton St., Muskegon, MI 49442 | 2018-05-21 |
| 1023524303 | Aaron James Dortch | Social Worker | 571 E Appleave, Muskegon, MI 49442 | 2017-12-21 |
| 1043737554 | Jessica Nicole Moskalewski | Social Worker | 125 E. Catherine, Muskegon, MI 49442 | 2017-08-25 |
| 1427587831 | Cristina J Walcott | Social Worker | 1611 Oak Avenue, Muskegon, MI 49442 | 2017-06-08 |
| 1538514518 | Andrew G Gregson | Internal Medicine | 1675 Leahy Street Suite 201a, Muskegon, MI 49442 | 2016-04-27 |
| 1487038287 | Mark Charles Kaufman | Social Worker | 1611 Oak Ave., Muskegon, MI 49442 | 2015-07-13 |
| 1841687027 | Erica Zaworski | Obstetrics & Gynecology | 1675 Leahy St #311a, Muskegon, MI 49442 | 2015-04-24 |
| Find all providers in zip 49442 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1598319915 | Hackley Community Care Center Inc | Clinic/Center | 2312 Denmark St, Muskegon, MI 49441-1479 | 2019-07-25 |
| 1255331583 | Mgh Family Health Center | Clinic/Center | 2201 S Getty St, Muskegon, MI 49444-1207 | 2005-07-28 |
| 1912506635 | Hackley Community Care Center Inc | Clinic/Center | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2020-10-23 |
| 1346600905 | Cherry Street Services Inc | Clinic/Center | 1611 Oak Ave, Muskegon, MI 49442-2468 | 2016-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1831706993 | Family Medical Center of Michigan, Inc | Clinic/Center | 503 Washington St Rm 150, Monroe, MI 48161-1309 | 2020-09-23 |
| 1326654666 | Family Medical Center of Michigan,inc | Clinic/Center | 550 E Main St Ste 1001, Hudson, MI 49247-9535 | 2020-09-22 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 1700400389 | Northwest Michigan Health Services, Inc. | Clinic/Center | 300 W Broadway Ave Trlr 1, Scottville, MI 49454-1019 | 2020-05-30 |
| 1679195721 | Family Medical Center of Michigan,inc | Clinic/Center | 2740 Collingwood St Ste 100, Detroit, MI 48206-1473 | 2020-05-12 |
| 1235750571 | Great Lakes Bay Health Centers | Clinic/Center | 2300 Veterans Memorial Pkwy, Saginaw, MI 48601-1268 | 2020-04-28 |
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1568096923 | Grace Health, Inc. | Clinic/Center | 825 Capital Ave Ne, Battle Creek, MI 49017-5605 | 2020-02-25 |
| 1336779131 | Northwest Michigan Health Services Inc. | Clinic/Center | 512 Bryant Ave., Room 23, Manistee, MI 49660-1839 | 2020-01-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.