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Organization
W.A. FOOTE MEMORIAL HOSPITAL, INC
Active
Organization
W.A. FOOTE MEMORIAL HOSPITAL, INC
Active
Parent organization
WA FOOTE MEMORIAL HOSPITAL, INC
Other names
Henry Ford Jackson Health, Henry Ford Allegiance Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
WA FOOTE MEMORIAL HOSPITAL, INC
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4800
Mailing address
PO BOX 670884, DETROIT, MI 48267-2728
(800) 999-5829
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500C810570
BCBSM CNP
MI
01
—
CC5829
RR MEDICARE
MI
Enumeration date
07/07/2006
Last updated
10/09/2026
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