HACKLEY COMMUNITY CARE CENTER INC
NPI 1386298552
Clinic/Center - Federally Qualified Health Center (FQHC) in Fruitport, MI
About Hackley Community Care Center Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HACKLEY COMMUNITY CARE CENTER INC (NPI 1386298552), doing business as Edgewood Elementary, is a healthcare organization registered as a federally qualified health center (fqhc) in Fruitport, Michigan and active in the NPI registry since July 2019. The organization lists Danielle Koestner, Cmo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Hackley Community Care Center Inc's NPI number?
The NPI number for Hackley Community Care Center Inc is 1386298552. It was assigned to this organization in the NPPES registry on July 26, 2019. The provider is doing business as Edgewood Elementary.
Where is Hackley Community Care Center Inc located?
Hackley Community Care Center Inc is located at 3255 Pontaluna Rd, Fruitport, MI 49415. The listed phone number is (231) 733-6720.
What is Hackley Community Care Center Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
When was this NPI record last updated?
The NPPES record for Hackley Community Care Center Inc was last updated on July 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Hackley Community Care Center Inc · NPI 1386298552
Federally Qualified Health Center (FQHC) organization in Fruitport, Michigan. Organization record, active in the CMS NPPES registry since July 26, 2019.
## Identity
- **NPI:** 1386298552 (Entity type: Organization)
- **Enumerated:** July 26, 2019
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** Edgewood Elementary (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Danielle Koestner, CMO
## Practice location
- **Address:** 3255 PONTALUNA RD, Fruitport, MI 49415-9600
- **Phone:** (231) 733-6720
## Record status
- **NPPES last updated:** July 26, 2019
- **Other identifiers:** Medicaid 1629066238 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1386298552) · Data from the CMS NPPES public registry.