Intercare Community Health Network

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

INTERCARE COMMUNITY HEALTH NETWORK

Practice address

960 Agard Ave
Benton Harbor, MI 49022-4051

Phone

(269) 927-5162

Fax

(269) 927-5319

NPI assigned

Mar 12, 2008

Organization subpart

No

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

Authorized official

Name

Velma Hendershott

Title

President/Ceo

Phone

(269) 427-7937

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1689845141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 INDUSTRIAL PARK DRIVE",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490131246",
            "telephone_number": "269-427-7937",
            "fax_number": "269-427-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 AGARD AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490224051",
            "telephone_number": "269-927-5162",
            "fax_number": "269-927-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCARE COMMUNITY HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "HENDERSHOTT",
        "authorized_official_first_name": "VELMA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "269-427-7937"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaia S. Hurley
• Brandon Ide
• Kayla Imler
• Intercare Community Health Network
• Intercare Community Health Network
• Intercare Community Health Network
• Intercare Community Health Network
• Intercare Community Health Network
• Katie M Iott
• Allison Ireland, LPC

• Federally Qualified Health Center (FQHC) in Benton Harbor, MI
• Providers in Benton Harbor, 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 Mar 12, 2008; 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.