Healthcare Provider Details

I. General information

NPI: 1992908883
Provider Name (Legal Business Name): HURON VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WILLIAM CARLS DR
COMMERCE TOWNSHIP MI
48382-2201
US

IV. Provider business mailing address

1 WILLIAM CARLS DR
COMMERCE TOWNSHIP MI
48382-2201
US

V. Phone/Fax

Practice location:
  • Phone: 248-937-3374
  • Fax: 248-937-3378
Mailing address:
  • Phone: 248-937-3374
  • Fax: 248-937-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM L LANTZY
Title or Position: VICE PRESIDENT FINANCE
Credential: VICE PRESIDENT
Phone: 248-937-3374