Great Lakes Bay Health Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GREAT LAKES BAY HEALTH CENTERS

Practice address

1309 Cleaver Rd
Caro, MI 48723

Phone

(989) 759-6464

Fax

(989) 399-8233

NPI assigned

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

Lisa Galonska

Title

Vice President

Phone

(989) 759-6464

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Great Lakes Bay Health Centers Tuscola County Other name

Locations

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1508060989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071208",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 CLEAVER RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "48723",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES BAY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "GALONSKA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "989-759-6464"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0G36111  MEDICARE  PAY BILL TO",
            "identifier": "0G36111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Bay Health Centers Tuscola County",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karley Autumn Glashauser, PT, DPT, CBIS
• Tina M Gomez, RN
• Shweta Gore
• Josephine Grannell, LMSW
• Great Lake Laboratories LLC
• Great Lakes Diagnostic Facility LLC
• Christine M Greer, RN
• Robert Grenn, MD
• Trevor A. Grice, PHD
• Kathy Ann Gwizdala, LMSW

• Federally Qualified Health Center (FQHC) in Caro, MI
• Providers in Caro, MI by specialty
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.