Provider Demographics
NPI:1033319462
Name:SAULT TRIBE OF CHIPPEWA INDIANS
Entity Type:Organization
Organization Name:SAULT TRIBE OF CHIPPEWA INDIANS
Other - Org Name:HESSEL COMMUNITY HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIVISION OF HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CULFA
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN
Authorized Official - Phone:906-632-5200
Mailing Address - Street 1:3355 N 3 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:HESSEL
Mailing Address - State:MI
Mailing Address - Zip Code:49745
Mailing Address - Country:US
Mailing Address - Phone:906-484-2727
Mailing Address - Fax:906-484-2139
Practice Address - Street 1:3355 N 3 MILE ROAD
Practice Address - Street 2:
Practice Address - City:HESSEL
Practice Address - State:MI
Practice Address - Zip Code:49745
Practice Address - Country:US
Practice Address - Phone:906-484-2727
Practice Address - Fax:906-484-2139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)