Healthcare Provider Details

I. General information

NPI: 1235261124
Provider Name (Legal Business Name): ST MARY MERCY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36475 5 MILE RD
LIVONIA MI
48154-1971
US

IV. Provider business mailing address

36475 5 MILE RD
LIVONIA MI
48154-1971
US

V. Phone/Fax

Practice location:
  • Phone: 734-655-4800
  • Fax: 734-655-1274
Mailing address:
  • Phone: 734-655-4800
  • Fax: 734-655-1274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number822312
License Number StateMI

VIII. Authorized Official

Name: DAVID SPIVEY
Title or Position: PREESIDENT & CEO
Credential:
Phone: 734-655-1611