| Organization Name: | NORTHERN HEALTH CENTERS INC |
| NPI Number: | 1073956223 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELE WHITE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 820 Arbutus Ave Oconto |
| State: | WI US |
| Postal Code: | 541532004 |
| Phone Number: | 9205167107 |
| Fax Number: | 9208352919 |
| NPI Enumeration Date: | 04/08/2013 |
| NPI Last Update Date: | 04/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 4757-800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |