NPIMap

Organization Active NPI

Hackley Community Care Center Inc

Doing business as Fruitport Middle School

  • Federally Qualified Health Center (FQHC)
  • Fruitport, MI
National Provider Identifier
1427658244
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HACKLEY COMMUNITY CARE CENTER INC
Doing business as
Fruitport Middle School
Practice address
3113 Pontaluna Rd Ste a
Fruitport, MI 49415-9600
Phone
(231) 733-6809
NPI assigned
Oct 30, 2020
Last updated
Oct 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Sheri Weglarz
Title
Coo
Phone
(231) 733-6610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3113 Pontaluna Rd Ste a
Fruitport, MI 49415-9600

Mailing address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Other names 1

  • Fruitport Middle School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hackley Community Care31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1427658244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 PONTALUNA RD STE A",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159600",
            "telephone_number": "231-733-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY COMMUNITY CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "WEGLARZ",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "231-733-6610"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fruitport Middle School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fruitport, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.