Provider Demographics
NPI:1518152735
Name:AQUINAS COLLEGE INC
Entity Type:Organization
Organization Name:AQUINAS COLLEGE INC
Other - Org Name:AQUINAS COLLEGE HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEXLEY-QUIGG
Authorized Official - Suffix:
Authorized Official - Credentials:RNC,NP
Authorized Official - Phone:616-632-2969
Mailing Address - Street 1:1607 ROBINSON RD SE
Mailing Address - Street 2:WEGE CENTER
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1741
Mailing Address - Country:US
Mailing Address - Phone:616-632-2970
Mailing Address - Fax:616-732-4580
Practice Address - Street 1:1607 ROBINSON RD SE
Practice Address - Street 2:WEGE CENTER
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1741
Practice Address - Country:US
Practice Address - Phone:616-632-2970
Practice Address - Fax:616-732-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704124474261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center