Provider Demographics
NPI:1598367740
Name:CATHERINES HEALTH CENTER
Entity Type:Organization
Organization Name:CATHERINES HEALTH CENTER
Other - Org Name:CATHERINE'S HEALTH DENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAASHOEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-336-8800
Mailing Address - Street 1:1211 LAFAYETTE AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-5092
Mailing Address - Country:US
Mailing Address - Phone:616-336-8800
Mailing Address - Fax:616-336-9700
Practice Address - Street 1:781 36TH ST SE STE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49548-2319
Practice Address - Country:US
Practice Address - Phone:616-336-8800
Practice Address - Fax:616-336-9700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHERINES HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-12
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)