| Organization Name: | MIDMICHIGAN HEALTH SERVICES |
| NPI Number: | 1912998287 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES P. RASCHKE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 9249 W Lake City Rd Houghton Lake |
| State: | MI US |
| Postal Code: | 486299602 |
| Phone Number: | 9894225122 |
| Fax Number: | 9894226838 |
| NPI Enumeration Date: | 11/04/2005 |
| NPI Last Update Date: | 04/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 4301068191 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |