CRISTO REY COMMUNITY CENTER NPI 1407800931

NPI Information

CRISTO REY COMMUNITY CENTER is a general practice in Lansing, MI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CRISTO REY COMMUNITY CENTER NPI is 1407800931. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1717 N HIGH ST
LANSING, MI
ZIP 48906-529
Phone: (517) 371-1700
Fax: (517) 371-4245

The provider's authorized official is Peter H Cooke .
The authorized official title is Medical Director and has the following contact phone number (517) 371-1700.

The CLIA number assigned to this NPI record is 23D0376202 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 6/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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