Healthcare Provider Details

I. General information

NPI: 1073588034
Provider Name (Legal Business Name): CARELINK OF JACKSON, A COMMUNITY-OWNED SPECIALTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 08/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N. ELM AVENUE
JACKSON MI
49202-3595
US

IV. Provider business mailing address

110 N. ELM AVENUE
JACKSON MI
49202-3595
US

V. Phone/Fax

Practice location:
  • Phone: 517-796-4475
  • Fax: 517-787-5226
Mailing address:
  • Phone: 517-796-4475
  • Fax: 517-787-5226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number380051
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. MARK SMITH
Title or Position: SVP - CMO, CEO - HFAMG
Credential:
Phone: 517-205-6407