Basic Information
| Provider Information | |||||||||
| NPI: | 1780807826 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNITY HEALING CENTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COMMUNITY HEALING CENTER STURGIS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 70050 M66 | ||||||||
| Address2: | |||||||||
| City: | STURGIS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490919431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2696511212 | ||||||||
| FaxNumber: | 2696598472 | ||||||||
| Practice Location | |||||||||
| Address1: | 70050 M66 | ||||||||
| Address2: | |||||||||
| City: | STURGIS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490919431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2696511212 | ||||||||
| FaxNumber: | 2696598472 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | PIOCH | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OPERATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2693431651 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BS | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | 750015 | MI | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.