Basic Information
| Provider Information | |||||||||
| NPI: | 1093180952 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAMILTON COMMUNITY HEALTH NETWORK, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 225 E 5TH ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485021641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8104064912 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1570 SUNCREST DR | ||||||||
| Address2: | |||||||||
| City: | LAPEER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484461154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106670500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2015 | ||||||||
| LastUpdateDate: | 01/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | PIERCE | ||||||||
| AuthorizedOfficialFirstName: | CLARENCE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8104064951 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.