OrganizationActive
Sedara Mae Healthcare Clinic, LLC
NPI 1265875892 · Community Health Clinic/Center · Grand Rapids, MI
Provider details
- NPI number
- 1265875892
- Entity type
- Organization
- Primary specialty
- Community Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Lisa Lucas, Practitioner
- License
- 4704237090 (MI)
Practice location
1167 Madison Ave Se
Mailbox 5
Grand Rapids, MI 49507-1200
Phone: (616) 301-1020
Mailing address
Po Box 8862
Kentwood, MI 49518-8862
Registry dates
- Enumerated
- 2013-04-12
- Last updated
- 2013-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.