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SEDARA MAE HEALTHCARE CLINIC, LLC
NPI 1265875892
Clinic/Center - Community Health in Grand Rapids, MI

Active since April 12, 2013
1167 MADISON AVE SE, MAILBOX 5, GRAND RAPIDS, MI 49507(616) 301-1020 Get Directions Write a Review

NPPES record last updated: April 25, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sedara Mae Healthcare Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEDARA MAE HEALTHCARE CLINIC, LLC (NPI 1265875892) is a healthcare organization registered as a community health in Grand Rapids, Michigan and active in the NPI registry since April 2013. The organization lists Lisa M Lucas, Practitioner, as its authorized official.

NPPES Registry Identity

NPI1265875892
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameSEDARA MAE HEALTHCARE CLINIC, LLC
Location Address1167 MADISON AVE SE, MAILBOX 5Grand Rapids, MI 49507-1200
Mailing AddressPo Box 8862Kentwood, MI 49518-8862 · (616) 301-1020
Phone(616) 301-1020
Organization SubpartNo
Authorized OfficialLisa M LucasPractitioner · (800) 363-4661
Enumeration DateApril 12, 2013
Last NPPES UpdateApril 25, 2013
✔ NPI 1265875892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
License✔ Licensed in MI · 4704237090
1167 MADISON AVE SE, Grand Rapids, MI 49507
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sedara Mae Healthcare Clinic, LLC's NPI number?

The NPI number for Sedara Mae Healthcare Clinic, LLC is 1265875892. It was assigned to this organization in the NPPES registry on April 12, 2013.

Where is Sedara Mae Healthcare Clinic, LLC located?

Sedara Mae Healthcare Clinic, LLC is located at 1167 Madison Ave SE Mailbox 5, Grand Rapids, MI 49507. The listed phone number is (616) 301-1020.

What is Sedara Mae Healthcare Clinic, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

When was this NPI record last updated?

The NPPES record for Sedara Mae Healthcare Clinic, LLC was last updated on April 25, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.