Active NPI
Northeast Michigan Community Mental Health Authority
- Community/Behavioral Health Agency
- Alpena, MI
National Provider Identifier
1144378381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- NORTHEAST MICHIGAN COMMUNITY MENTAL HEALTH AUTHORITY
- Practice address
- 400 Johnson St
Alpena, MI 49707-1434 - Phone
- (989) 356-2161
- Fax
- (989) 354-5898
- NPI assigned
- Jan 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Charles A White
- Title
- Executive Director
- Phone
- (989) 356-2161
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
400 Johnson St
Alpena, MI 49707-1434
Mailing address
400 Johnson St
Alpena, MI 49707-1434
Phone (989) 356-2161
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4352772 | Medicaid | MI | |
| 4458332 | Medicaid | MI | |
| 1708100 | Medicaid | MI | |
| 26-0-Z4-1060-0 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041203000522 | MI | Part B Supplier - Clinic/Group Practice | 2264498005 |
Receives reassigned benefits from 23 practitioners Practice locations: Alpena, MI; Hillman, MI; Rogers City, MI |
National Provider Directory
National Provider DirectoryLocations
109 N Second Ave
Alpena, MI 49707
318 W Fletcher St
Alpena, MI 49707
Phone (989) 358-7660
630 Caring St
Hillman, MI 49746
Phone (989) 742-4549
156 N 4th St
Rogers City, MI 49779
Phone (989) 734-7223
Practitioners & affiliated clinicians
Practitioners 212
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168041600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1222905600000",
"number": "1144378381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 JOHNSON ST",
"city": "ALPENA",
"state": "MI",
"postal_code": "497071434",
"telephone_number": "989-356-2161",
"fax_number": "989-354-5898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 JOHNSON ST",
"city": "ALPENA",
"state": "MI",
"postal_code": "497071434",
"telephone_number": "989-356-2161",
"fax_number": "989-354-5898"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEAST MICHIGAN COMMUNITY MENTAL HEALTH AUTHORITY",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-06",
"last_updated": "2008-10-02",
"status": "A",
"authorized_official_last_name": "WHITE",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "989-356-2161",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4352772",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4458332",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1708100",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
"identifier": "26-0-Z4-1060-0",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alpena, MI
- Nichols Optical Inc
- Jessica Sue Niles
- Dorien L Noble, RN CDP
- North Eastern Michigan Cancer Center
- North Eastern Michigan Rehabilitation and Opportunity Center, Inc.
- Northeast Michigan Community Mental Health Authority
- Northeast Michigan Community Service Agency
- Northeast Michigan Community Service Agency, Inc.
- Northeast Michigan Home Health Care
- Northeastern Michigan Cancer Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.