Healthcare Provider Details

I. General information

NPI: 1003859380
Provider Name (Legal Business Name): STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 PLATT RD
SALINE MI
48176-9773
US

IV. Provider business mailing address

8303 PLATT RD
SALINE MI
48176-9773
US

V. Phone/Fax

Practice location:
  • Phone: 734-429-2531
  • Fax: 734-429-2390
Mailing address:
  • Phone: 734-295-4512
  • Fax: 734-944-0802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301005874
License Number StateMI

VIII. Authorized Official

Name: ANDREA LYNN VANDENBERGH
Title or Position: HOSPITAL DIRECTOR
Credential:
Phone: 734-295-4512