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General NPI Number Information
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NPI Number | 1568675817
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Entity Type | Organization
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Legal Business Name | BON SECOURS COTTAGE HEALTH SERVICES
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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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 | 313-640-2537
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 VAN ANTWERP ST
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City | GROSSE POINTE WOODS
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State | MI
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Zip | 48236-1624
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Country | US
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Telephone | 313-213-8505
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR PSYCHIATRIC INTAKE
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Name | MS. MELISSA VAL ALTOMARE
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Credential | MSW, LMSW, ACSW,BCD
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Telephone | 313-640-2537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 6801076906
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License Number State | MI
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