Healthcare Provider Details

I. General information

NPI: 1962586123
Provider Name (Legal Business Name): W.A. FOOTE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVE ONE JACKSON SQUARE, SUITE 400
JACKSON MI
49201-1753
US

IV. Provider business mailing address

1 FORD PL STE 2E
DETROIT MI
48202-3450
US

V. Phone/Fax

Practice location:
  • Phone: 517-841-6982
  • Fax: 517-841-6987
Mailing address:
  • Phone: 313-874-4806
  • Fax: 313-876-1305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number380010
License Number StateMI

VIII. Authorized Official

Name: ROBIN DAMSCHRODER
Title or Position: PRESIDENT, VAL BASED ENT & CFO
Credential:
Phone: 313-876-8452