| Ascension Providence Hospital | |
|
16001 W. 9 Mile Road Southfield MI 48075-4818 | |
| (243) 349-3000 | |
| (248) 746-0384 |
| Full Name | Ascension Providence Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 16001 W. 9 Mile Road, Southfield, Michigan |
| Authorized Official Name and Position | Joseph Hurshe (PRESIDENT) |
| Authorized Official Contact | 2433493400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Providence Hospital 16001 W 9 Mile Rd Southfield MI 48075-4818 Ph: () - | Ascension Providence Hospital 16001 W. 9 Mile Road Southfield MI 48075-4818 Ph: (243) 349-3000 |
| NPI Number | 1003892092 |
|---|---|
| Provider Enumeration Date | 12/21/2005 |
| Last Update Date | 06/28/2022 |
| Certification Date | 06/28/2022 |
| Medicare PECOS PAC ID | 6103738703 |
|---|---|
| Medicare Enrollment ID | O20070221000327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003892092 | NPI | - | NPPES |
| 20277 | Other | MI | BLUE CROSS |
| 1557875 | Medicaid | MI | |
| 21277 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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