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General NPI Number Information
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NPI Number | 1114009032
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Entity Type | Organization
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Legal Business Name | HENRY FORD HEALTH SYSTEM
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 159 KERCHEVAL AVE
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3610
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Country | US
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Telephone | 313-640-1000
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Fax | 313-884-8927
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Provider Business Mailing Address
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Address Line | 1 FORD PL
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 586-498-4960
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Fax | 586-498-4936
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Authorized Official
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Title or Position | CFO
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Name | JAMES CONNELLY
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Credential |
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Telephone | 313-876-8714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | H-630001
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License Number State | MI
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