NPIMap

Organization Active NPI

Hackley Community Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
National Provider Identifier
1629645072
Registry record updated Jun 4, 2021
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
Practice address
1212 Kingsley St RM 106
Muskegon, MI 49442-4025
Phone
(231) 737-1335
NPI assigned
Jun 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Valerie Blondin
Title
Cfo
Phone
(231) 733-6657

Specialties & licenses 1

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

Addresses

Primary practice location

1212 Kingsley St RM 106
Muskegon, MI 49442-4025

Mailing address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Other names 1

  • Three Oaks Charter Academy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hackley Community Care30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 4

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": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1629645072",
    "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": "1212 KINGSLEY ST RM 106",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494424025",
            "telephone_number": "231-737-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY COMMUNITY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "BLONDIN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "231-733-6657"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Oaks Charter Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.