| Saint Mary's Health Care | |
|
200 Jefferson Ave Se Grand Rapids MI 49503-4502 | |
| (616) 643-3500 | |
| (616) 643-3659 |
| Full Name | Saint Mary's Health Care |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 200 Jefferson Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Dan Green (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 6166856709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Mary's Health Care 1820 44th St Se Kentwood MI 49508-5006 Ph: (616) 643-3500 | Saint Mary's Health Care 200 Jefferson Ave Se Grand Rapids MI 49503-4502 Ph: (616) 643-3500 |
| NPI Number | 1467480566 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 10/14/2015 |
| Medicare PECOS PAC ID | 4981500436 |
|---|---|
| Medicare Enrollment ID | O20071210000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467480566 | NPI | - | NPPES |
| 3203778 | Medicaid | MI | |
| 2683284 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H-107/2005 (Michigan) | Primary |
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