Provider Demographics
NPI:1114358140
Name:HOLLAND FREE HEALTH CLINIC
Entity Type:Organization
Organization Name:HOLLAND FREE HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-392-3610
Mailing Address - Street 1:99 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4970
Mailing Address - Country:US
Mailing Address - Phone:616-392-3610
Mailing Address - Fax:616-392-3632
Practice Address - Street 1:99 W 26TH ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4970
Practice Address - Country:US
Practice Address - Phone:616-392-3610
Practice Address - Fax:616-392-3632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare