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Organization
ST. JOHN PROVIDENCE HEALTH SYSTEM
Active
Organization
ST. JOHN PROVIDENCE HEALTH SYSTEM
Active
Parent organization
ST. JOHN PROVIDENCE HEALTH SYSTEM
Other names
St. John Macomb Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. JOHN PROVIDENCE HEALTH SYSTEM
Authorized official
MRS. CHRISTINA MARIA POPE MA LPC (BEHAVIORAL HEALTH INTAKE CLINICIAN)
(586) 573-5872
Entity
Organization
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5872
(586) 573-5583
Mailing address
11800 EAST TWELVE MILE ROAD, WARREN, MI 48093
(586) 573-5872
(586) 573-5583
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
6401007085
MI
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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