NPIMap

Organization Active NPI

Upper Great Lakes Family Health Center

Doing business as UGLFHC Lake Linden School

  • Federally Qualified Health Center (FQHC)
  • Lake Linden, MI
National Provider Identifier
1780318345
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Doing business as
UGLFHC Lake Linden School
Practice address
601 Calumet St
Lake Linden, MI 49945-1002
Phone
(906) 483-1705
Fax
(906) 372-3230
NPI assigned
Jul 11, 2022
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Trevor Hodges
Title
Ceo
Phone
(906) 483-1846

Specialties & licenses 1

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

Addresses

Primary practice location

601 Calumet St
Lake Linden, MI 49945-1002

Mailing address

135 E M35
Gwinn, MI 49841-9160
Phone (906) 483-1705

Other names 1

  • UGLFHC Lake Linden School Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230224001412 MI Part A Provider - Federally Qualified Health Center (FQHC) 1951432384 Practice locations: Lake Linden, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780318345. Details of each certification follow.

Federally qualified health center certification: CCN 231193

Legal name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Doing business as
UGLFHC LAKE LINDEN SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 26, 2023
Last certification
Jan 26, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2022 in MI
Enrollment address
601 Calumet St
Lake Linden, MI 49945-1002

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Upper Great Lakes Center18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

601 Calumet St
Lake Linden, MI 49945
Phone 90629662212104

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tanya Johnson Individual Corporate OfficerBoard Member Oct 28, 2020
Trevor Hodges Individual Corporate DirectorCfo Jan 1, 2020
W-2 Managing EmployeeCfo Jan 1, 2020
Mark Rouleau Individual Corporate OfficerBoard Member Nov 24, 2021
Stephen Vairo Individual Corporate OfficerBoard Member Oct 7, 2009
Donald Simila Individual Corporate DirectorCeo Dec 10, 2010
W-2 Managing EmployeeCeo Dec 10, 2010
Kevin L Piggott Individual Corporate OfficerBoard Member Oct 31, 2018
Cathryn Beer Individual Corporate OfficerBoard Member Oct 26, 2016
Dianna Christenson Individual Corporate OfficerBoard Member Dec 4, 2013
Christopher Adams Individual Corporate OfficerBoard Member Jun 26, 2019
Julie Shaw Individual Corporate OfficerBoard Member Sep 25, 2019
Allen Mott Individual Corporate OfficerBoard Member Mar 28, 2018
Micah Stipech Individual Corporate OfficerBoard Member Mar 25, 2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1780318345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E M35",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498419160",
            "telephone_number": "906-483-1705",
            "fax_number": "906-372-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CALUMET ST",
            "city": "LAKE LINDEN",
            "state": "MI",
            "postal_code": "499451002",
            "telephone_number": "906-483-1705",
            "fax_number": "906-372-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER GREAT LAKES FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-483-1846"
    },
    "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": "UGLFHC Lake Linden School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UGLFHC Lake Linden School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Linden, MI

Sources for this page

Verify at the official NPI Registry.