UPPER GREAT LAKES FAMILY HEALTH CENTER


Address: 1500 W Ice Lake Road, Iron River, MI 49935-8509
Phone: 9062655378

UPPER GREAT LAKES FAMILY HEALTH CENTER (NPI# 1508289273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508289273
Entity Type Organization
Organization Name UPPER GREAT LAKES FAMILY HEALTH CENTER
Other Organization Name ICE LAKE FAMILY HEALTH CENTER
Practice Address 1500 W Ice Lake Road
Iron River
MI 49935-8509
Mailing Address 506 Campus Drive
Hancock
MI 49930-1569
Practice Telephone 9062655378
Practice Fax Number 9062654245
Mailing Telephone 9064831705
Mailing Fax Number 9064831394
Enumeration Date 2014-01-30
Last Update Date 2016-04-18
Authorized Official Name DONALD A SIMILA (CEO)
Authorized Official Telephone 9064831325
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
MI Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Ice Lake Family Health Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1053948265 Upper Great Lakes Family Health Center Clinic/Center 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 2020-03-26
1659889673 Upper Great Lakes Family Health Center Psychiatry & Neurology 965 Fee Rd Rm A229, East Lansing, MI 48824-6410 2018-01-11
1336563832 Upper Great Lakes Family Health Center Clinic/Center 751 S 7th Street, Ontonagon, MI 49953-1450 2014-02-05
1740603885 Upper Great Lakes Family Health Center Clinic/Center 945 Ninth Street, Lake Linden, MI 49945-1100 2014-01-25
1811325103 Upper Great Lakes Family Health Center Clinic/Center 600 Macinnes Drive, Houghton, MI 49931-1144 2013-10-23
1700103777 Upper Great Lakes Family Health Center Family Medicine 301 Explorer Street, Gwinn, MI 49841-2813 2010-04-29
1104158690 Upper Great Lakes Family Health Center Family Medicine 135 East M 35, Gwinn, MI 49841-9159 2010-02-08
1396295721 Upper Great Lakes Family Health Center Dentist 56720 Calumet Ave, Calumet, MI 49913-1967 2016-10-10
1164893491 Upper Great Lakes Family Health Center Dentist 301 Explorer St, Gwinn, MI 49841-2813 2015-10-13
1205217239 Upper Great Lakes Family Health Center Dentist 1550 W Quincy St, Hancock, MI 49930-1223 2015-06-16

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities UPPER GREAT LAKES FAMILY HEALTH CENTER 506 Campus Dr, Hancock, MI 49930-1569

Office Location

Street Address 1500 W ICE LAKE ROAD
City IRON RIVER
State MI
Zip Code 49935-8509

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457865198 Aspirus Iron River Hospital & Clinics, Inc. Clinic/Center 814 South Ice Lake Road, Iron River, MI 49935 2017-11-16
1659807808 Shannon Koski Specialist/Technologist 1800 N Verona Ave, Iron River, MI 49935 2017-05-10
1912166166 Rk Atanasoff Od PC Optometrist 131 W Genesee St, Iron River, MI 49935 2008-06-03
1215102272 Aspirus Iron River Hospital & Clinics, Inc. Pathology 1400 West Ice Lake Road, Iron River, MI 49935 2008-04-29
1164620555 Mary Jo Rohde Social Worker 1201 Stambough Ave, Iron River, MI 49935 2007-07-06
1861693848 Michael Wallace Varney Psychologist 217 North 10th Avenue, Iron River, MI 49935 2007-05-29
1962616623 Advanced Care Smile Center Inc Dentist 528 N 1st Avenue, Iron River, MI 49935 2007-05-10
1376551788 Raymond Krist Atanasoff Optometrist 131 W Genesee Street, Iron River, MI 49935 2006-08-03
1205873510 Raymond J Meyers Nurse Anesthetist, Certified Registered 1400 Ice Lake Rd., Iron River, MI 49935 2006-06-02
1497750830 Aspirus Iron River Hospital & Clinics, Inc. General Acute Care Hospital 1400 W Ice Lake Rd, Iron River, MI 49935 2005-06-14
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811178825 The Lakes Community Health Center, Inc Clinic/Center 7665 Us Hwy 2, Iron River, WI 54847-4690 2007-11-19

Providers in the same taxonomy and state

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
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
Find all providers with the same taxonomy

Competitor

Search similar providers

City IRON RIVER
Zip Code 49935

Improve Information

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Dataset Information

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.

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