NPIMap

Organization Active NPI

The Four Health Family Resource Center Inc

  • Professional Counselor
  • Saranac, MI
National Provider Identifier
1073989141
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401014973 Issued in MI
Legal business name
THE FOUR HEALTH FAMILY RESOURCE CENTER INC
Practice address
92 N Bridge St
Saranac, MI 48881
Phone
(616) 642-6466
Fax
(616) 642-6621
NPI assigned
Aug 12, 2015
Last updated
May 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Beth Houpt
Title
Credentialing
Phone
(517) 676-9788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401014973 MI Primary

Addresses

Primary practice location

92 N Bridge St
Saranac, MI 48881

Mailing address

92 N Bridge St
P O Box 178
Saranac, MI 48881-5102
Phone (616) 642-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180913000109 MI Part B Supplier - Clinic/Group Practice 7618227604 Receives reassigned benefits from 9 practitioners
Practice locations: Saranac, MI

National Provider Directory

National Provider Directory

Locations

2730 5 Mile Rd NE
Grand Rapids, MI 49525
Phone (616) 361-6601

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1073989141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 N BRIDGE ST",
            "address_2": "P O BOX 178",
            "city": "SARANAC",
            "state": "MI",
            "postal_code": "488815102",
            "telephone_number": "616-642-6466",
            "fax_number": "616-642-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 N BRIDGE ST",
            "city": "SARANAC",
            "state": "MI",
            "postal_code": "48881",
            "telephone_number": "616-642-6466",
            "fax_number": "616-642-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOUR HEALTH FAMILY RESOURCE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9788"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saranac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.