HENRY FORD MACOMB HOSPITAL CORPORATION (NPI# 1568643195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568643195 |
| Entity Type | Organization |
| Organization Name | HENRY FORD MACOMB HOSPITAL CORPORATION |
| Other Organization Name | HENRY FORD MACOMB HOSPITAL |
| Practice Address |
15855 19 Mile Rd Clinton Twp MI 48038-3504 |
| Mailing Address |
215 North Ave Mount Clemens MI 48043-1716 |
| Practice Telephone | 5862632705 |
| Mailing Telephone | 5862632705 |
| Mailing Fax Number | 5862632255 |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2010-12-30 |
| Authorized Official Name | MR. TERRY GOODBALIAN (REGIONAL VP FINANCE, CFO) |
| Authorized Official Telephone | 5862632705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS OP SUBSTANCE ABUSE | 20315 | 01 |
| Other Name | Type Code |
|---|---|
| Henry Ford Macomb Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437532959 | Henry Ford Macomb Hospital Corporation | Clinic/Center | 155 Cass Ave, Mount Clemens, MI 48043-2203 | 2015-07-01 |
| 1225171218 | Henry Ford Macomb Hospital Corporation | Counselor | 43411 Garfield Rd, Clinton Township, MI 48038-1152 | 2007-02-15 |
| 1902842735 | Henry Ford Macomb Hospital Corporation | General Acute Care Hospital | 13355 East 10 Mile Rd, Warren, MI 48089-2048 | 2006-06-21 |
| 1912301094 | Henry Ford Macomb Hospital Corporation | Nurse Practitioner | 1 Ford Pl, Suite 2e, Detroit, MI 48202-3450 | 2014-10-17 |
| 1124421888 | Henry Ford Macomb Hospital Corporation | Physician Assistant | 1 Ford Pl, Suite 2e, Detroit, MI 48202-3450 | 2014-10-08 |
| 1790069714 | Henry Ford Macomb Hospital Corporation | Orthopaedic Surgery | 15520 19 Mile Rd, Suite 430, Clinton Township, MI 48038-6333 | 2011-10-10 |
| 1073844106 | Henry Ford Macomb Hospital Corporation | Nurse Anesthetist, Certified Registered | 13355 E 10 Mile Rd, Warren, MI 48089-2048 | 2010-01-29 |
| 1205060076 | Henry Ford Macomb Hospital Corporation | Clinic/Center | 80650 Van Dyke Rd, Bruce Twp, MI 48065-1333 | 2009-05-08 |
| 1194869107 | Henry Ford Macomb Hospital Corporation | Clinical Neuropsychologist | 43411 Garfield Rd, Clinton Township, MI 48038-1152 | 2007-02-16 |
| 1003950015 | Henry Ford Macomb Hospital Corporation | Psychiatry & Neurology | 43411 Garfield Rd, Clinton Township, MI 48038-1152 | 2007-02-16 |
| Street Address |
15855 19 MILE RD |
| City | CLINTON TWP |
| State | MI |
| Zip Code | 48038-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811991177 | Timothy Peter Boufford | Internal Medicine | 15855 19 Mile Rd, Henry Ford Macomb, Clinton Twp, MI 48038-3504 | 2005-06-02 |
| 1144857400 | Brent Geers | Orthopaedic Surgery | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2020-03-26 |
| 1245867118 | Michael Sochacki | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2020-03-23 |
| 1184259459 | Christina Lynn James | Nurse Practitioner | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2020-03-07 |
| 1417596396 | Amanda Marie Disanto | Nurse Anesthetist, Certified Registered | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-12-25 |
| 1114566189 | Jeffrey M Kirby | Nurse Anesthetist, Certified Registered | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-12-23 |
| 1164071783 | Ryan Amber Beebe | Nurse Practitioner | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-09-06 |
| 1215590583 | Sharan Mullen | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-04-22 |
| 1669934873 | Haley Svrcina Lehman | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-04-05 |
| 1336600311 | Joseph Gerald Lucido | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2019-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821311341 | Peer Choices, Inc. | Rehabilitation, Substance Use Disorder Unit | 255 N Telegraph Rd Ste 206, Waterford, MI 48328-3355 | 2010-03-11 |
| 1174720080 | St Joseph Mercy Hospital | Rehabilitation, Substance Use Disorder Unit | 5401 Mcauley Drive, Ypsilanti, MI 48197-1011 | 2007-07-03 |
| 1235749219 | Joel Darnell Dewberry | Rehabilitation, Substance Use Disorder Unit | 20102 Harper Ave, Harper Woods, MI 48225-1712 | 2020-08-05 |
| 1417570128 | Sheridan Community Hospital | Rehabilitation, Substance Use Disorder Unit | 301 N Main St, Sheridan, MI 48884-9235 | 2020-05-28 |
| 1417589086 | Black Rock Recovery, LLC | Rehabilitation, Substance Use Disorder Unit | 25235 Orchard Lake Rd, Farmington Hills, MI 48336-1233 | 2020-02-11 |
| 1053722280 | Eagle Advancement Institute | Rehabilitation, Substance Use Disorder Unit | 7091 Orchard Lake Rd, Suite 200, West Bloomfield, MI 48322-3654 | 2014-05-09 |
| 1174871305 | Dlp Marquette General Hospital LLC | Rehabilitation, Substance Use Disorder Unit | 420 W Magnetic St, Marquette, MI 49855-2700 | 2012-08-20 |
| 1932363454 | Munson Medical Center | Rehabilitation, Substance Use Disorder Unit | 1105 6th St, Traverse City, MI 49684-2345 | 2008-07-14 |
| 1487817680 | Alpena Regional Medical Center-bhs | Rehabilitation, Substance Use Disorder Unit | 1501 W Chisholm St, Alpena, MI 49707-1401 | 2008-07-08 |
| 1598949794 | Healthsource Saginaw Inc | Rehabilitation, Substance Use Disorder Unit | 3340 Hospital Rd, Saginaw, MI 48603-9622 | 2007-12-24 |
| Find all providers with the same taxonomy | ||||
| City | CLINTON TWP |
| Zip Code | 48038 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.