# LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285651760
- **Authorized official:** MR. TIM CALHOUN (CFO/VP OF FINANCE)
- **Authorized official phone:** (269) 983-8398

## Contact information

- **Practice address:** 6418 DEANS HILL RD, BERRIEN CENTER, MI 49102-9750
- **Practice address phone:** (269) 473-3003
- **Practice address fax:** (269) 473-3010
- **Mailing address:** PO BOX 800, SAINT JOSEPH, MI 49085-0800
- **Mailing address phone:** (269) 428-2574
- **Mailing address fax:** (269) 428-0490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 113010 | MI | Yes |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 06/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4164932 | — | MI |
| 01 | — | S9516 | BLUE CROSS | — |