Organization · Type 2 NPI

Sault Tribe of Chippewa Indians

Federally Qualified Health Center (FQHC) · De Tour Village, MI

NPI number 1861545337 Active

Practice location

346 Superior St
De Tour Village, MI 49725

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	231875

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1861545337
Entity type: Organization (Type 2)
Issued: Jan 19, 2007
Last updated: Jul 10, 2007
Status: Active
Subpart: Yes of Sault Tribe of Chippewa Indians

Other names

<unavail>
Detour Village Medical Center · other name

Authorized official

Bonnie Culfa, RN MSN
Health Director
(906) 632-5200

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1861545337

Sault Tribe of Chippewa Indians's National Provider Identifier is 1861545337, issued on Jan 19, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in De Tour Village, MI. The record was last updated on Jul 10, 2007.