Hackley Community Care Center Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

HACKLEY COMMUNITY CARE CENTER INC

Practice address

1150 Amity Ave
Muskegon, MI 49442-3713

Phone

(231) 720-3048

NPI assigned

May 26, 2015

Organization subpart

No

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

Authorized official

Name

Wayne Kohn, DO

Title

Cmo

Phone

(231) 737-1335

Specialties & licenses 2

Addresses

Other names 1

• Muskegon Middle School Doing business as

Locations

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1962881862",
    "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",
            "telephone_number": "231-737-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 AMITY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494423713",
            "telephone_number": "231-720-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY COMMUNITY CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "231-737-1335",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muskegon Middle School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center Inc
• Hackley Community Care Center, Inc
• Hackley Community Care Center, Inc
• Hackley Community Care Center, Inc
• Hackley Community Care Center, Inc
• Hackley Community Care Center, Inc

• Federally Qualified Health Center (FQHC) in Muskegon, MI
• Providers in Muskegon, 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 Jun 8, 2015; 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.