Provider Demographics
NPI:1609099738
Name:ALCONA CITIZENS FOR HEALTH, INC.
Entity Type:Organization
Organization Name:ALCONA CITIZENS FOR HEALTH, INC.
Other - Org Name:ALCONA HEALTH CENTER-OSSINEKE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-358-0673
Mailing Address - Street 1:11745 US HIGHWAY 23 S
Mailing Address - Street 2:P.O. BOX 83
Mailing Address - City:OSSINEKE
Mailing Address - State:MI
Mailing Address - Zip Code:49766-9582
Mailing Address - Country:US
Mailing Address - Phone:989-471-2156
Mailing Address - Fax:989-358-3750
Practice Address - Street 1:11745 US HIGHWAY 23 S
Practice Address - Street 2:
Practice Address - City:OSSINEKE
Practice Address - State:MI
Practice Address - Zip Code:49766-9582
Practice Address - Country:US
Practice Address - Phone:989-471-2156
Practice Address - Fax:989-358-3750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
231826Medicare Oscar/Certification