Provider Demographics
NPI:1578073391
Name:ALCONA CITIZENS FOR HEALTH, INC.
Entity Type:Organization
Organization Name:ALCONA CITIZENS FOR HEALTH, INC.
Other - Org Name:AHC OSCODA AREA HIGH SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-358-0673
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0655
Mailing Address - Country:US
Mailing Address - Phone:989-736-9815
Mailing Address - Fax:
Practice Address - Street 1:3550 E RIVER RD
Practice Address - Street 2:
Practice Address - City:OSCODA
Practice Address - State:MI
Practice Address - Zip Code:48750-9025
Practice Address - Country:US
Practice Address - Phone:989-739-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALCONA CITIZENS FOR HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1326055450Medicaid