Pokagon Band of Potawatomi Indians
Organization Active NPI Social Worker · Dowagiac, MI
NPI 1225185705 · NPPES record last updated Sep 16, 2019
Key facts
- NPI
- 1225185705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Social Worker 104100000X
- Legal business name
- POKAGON BAND OF POTAWATOMI INDIANS
- Practice address
- 32652 Kno
Dowagiac, MI 49047 - Phone
- (269) 782-4141
- Fax
- (269) 782-1236
- NPI assigned
- Jan 5, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- POKAGON BAND OF POTAWATOMI INDIANS
Authorized official
- Name
- Mr. Matt Clay
- Title
- Director of Health Services
- Phone
- (269) 782-4141
Corporate family (same tax ID) 2
Practitioners 2
-
Kaylyn Bussard, MSW
National Provider Directory
- Tax ID family
- Pokagon Band of Potawatomi Indians
- Part of
- Pokagon Band of Potawatomi Indians
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | Yes | ||
| Registered Dietitian |
133V00000X | |||
| Community Health Registered Nurse |
163WC1500X | |||
| Psychiatry Physician |
2084P0800X |
Addresses
Primary practice location
32652 Kno
Dowagiac, MI 49047
Mailing address
PO Box 180
Dowagiac, MI 49047-0180
Other practice location 1
32652 Kno
Dowagiac, MI 49047
Phone (269) 782-4141
Other names
- Pokagon Health Services
- Pokagon Band Health Services
Other providers in Dowagiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.