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General NPI Number Information
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NPI Number | 1912094525
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Entity Type | Organization
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Legal Business Name | LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 2550 MEADOWBROOK RD SUITE 110
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City | BENTON HARBOR
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State | MI
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Zip | 49022-9609
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Country | US
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Telephone | 269-985-4400
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Fax | 269-985-4446
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Provider Business Mailing Address
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Address Line | PO BOX 813
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-0813
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Country | US
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Telephone | 269-985-4400
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Fax | 269-985-4446
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW E COX
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Credential |
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Telephone | 616-391-1663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 110050
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License Number State | MI
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