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CHC08752-01 LAKELAND IMMEDIATE CARE CENTER (Terminated)
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Main Details
Name
LAKELAND IMMEDIATE CARE CENTER
Subdivision Name
Cass Family Clinic OB/GYN
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008188
340B ID
CHC08752-01
Grant Number
H80CS08752
Additional Details
Current Program Status
Terminated
Registration Date
2/22/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/10/2010
Last Recertification Date
2/1/2023
Termination Date
Termination Reason
4/1/2024
Other
Contacts
Authorizing Official
Cassopolis Family Clinic Network
MARY GEEGAN MIDDLETON, Chief Executive Officer
(269) 445-3874 Ext: 109
Primary Contact
Niles Community Health Center Pharmacy
Kevin Klipowicz, Pharmacy Director
(269) 665-8900
Addresses
Street Address
1951 Oak St.
Niles, MI 49120-3738
Billing Address
LAKELAND IMMEDIATE CARE CENTER
261 M-62
CASSOPOLIS, MI 49031-1034
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/28/12 - Changed email of AO and Contact from, mmiddleton@lakelandregional.org
03/28/2012
May 2025
May 2025
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