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Lac Vieux Desert Band Of Lake Superior Chippewa Indians
Federally Qualified Health Center (FQHC) in Watersmeet, Michigan
NPI 1114071578

Lac Vieux Desert Band Of Lake Superior Chippewa Indians is a Federally Qualified Health Center (FQHC) based in Watersmeet, MI and is specialized in Federally Qualified Health Center (FQHC). Lac Vieux Desert Band Of Lake Superior Chippewa Indians practices in Watersmeet, MI. The NPI Number for Lac Vieux Desert Band Of Lake Superior Chippewa Indians is 1114071578 and holds a License No. (Michigan).

The current practice location address for Lac Vieux Desert Band Of Lake Superior Chippewa Indians is N5241 Us Highway 45, Watersmeet, MI and can be reached out via phone at 906-358-4588 and via fax at 906-358-4118.

Location: N5241 Us Highway 45, Watersmeet, MI, 49969-0009
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1114071578
Provider Name
Lac Vieux Desert Band Of Lake Superior Chippewa Indians
Credential
Provider Entity Type
Organization
Address
N5241 Us Highway 45, Watersmeet, MI, 49969-0009
Phone Number
906-358-4588
Fax Number
906-358-4118
Provider Enumeration Date
01/23/2007
Last Update Date
02/15/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
OB74513 01 MI BLUE CROSS BLUE SHIELD
1114071578 05 MI
institution
Provider Business Practice Location Address Details
Address
N5241 Us Highway 45
City
Watersmeet
State
Michigan
Zip
49969-0009
Phone Number
906-358-4588
Fax Number
906-358-4118
person
Provider Business Mailing Address Details
Address
N5241 Us Highway 45
City
Watersmeet
State
Michigan
Zip
49969-0009
Phone Number
906-358-4588
Fax Number
906-358-4118
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
261QF0400X
License No.
()
Definition
Definition to come...
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