Provider Demographics
NPI:1821610965
Name:MCLAREN CENTRAL MICHIGAN
Entity Type:Organization
Organization Name:MCLAREN CENTRAL MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOULES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-772-6818
Mailing Address - Street 1:1221 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3257
Mailing Address - Country:US
Mailing Address - Phone:989-772-6700
Mailing Address - Fax:
Practice Address - Street 1:4489 M 61
Practice Address - Street 2:STES 1, 2
Practice Address - City:STANDISH
Practice Address - State:MI
Practice Address - Zip Code:48658-9273
Practice Address - Country:US
Practice Address - Phone:989-846-2600
Practice Address - Fax:989-846-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health