Healthcare Provider Details

I. General information

NPI: 1194771030
Provider Name (Legal Business Name): ASCENSION BORGESS LEE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 WEST HIGH STREET
DOWAGIAC MI
49047-1943
US

IV. Provider business mailing address

1717 SHAFFER STREET SUITE 002
KALAMAZOO MI
49048
US

V. Phone/Fax

Practice location:
  • Phone: 269-782-8681
  • Fax:
Mailing address:
  • Phone: 269-552-2830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberSFE1414003186
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number1060000082
License Number StateMI

VIII. Authorized Official

Name: MARINA HOUGHTON
Title or Position: CFO
Credential:
Phone: 269-226-4800