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Organization

ST MARY MERCY HOSPITAL PROFESSIONAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL P GUSHO (SEMI REGIONAL CFO)
(248) 858-6174
Entity
Organization

Contact information

Practice address
2006 HOGBACK RD, SUITE 1, ANN ARBOR, MI 48105-9750
(734) 786-2300
Mailing address
36475 5 MILE RD, LIVONIA, MI 48154-1971
(734) 655-4800

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
10/10/2016
Last updated
10/17/2016
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