Organization
HENRY FORD HEALTH SYSTEM
Active
Other names
Center for Senior Independence
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SIMOWSKI (EXECUTIVE DIRECTOR)
(313) 653-2222
Entity
Organization
Contact information
Practice address
7800 W OUTER DR, STE.240, DETROIT, MI 48235-3461
(313) 653-2020
(313) 653-2779
Mailing address
7800 W OUTER DR, STE.240, DETROIT, MI 48235-3461
(313) 653-2020
(313) 653-2779
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
H2318
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4070184
—
MI
01
—
H2318
MEDICARE CONTRACT #/HIC#
MI
Enumeration date
09/11/2007
Last updated
07/29/2008
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