Organization
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Active
Other names
Henry Ford Health Providence Hospital, Henry Ford Health Providence Novi Hospital, Henry Ford Health Providence Southfield Hospital, Henry Ford Providence Hospital, Henry Ford Providence Southfield Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR OF PROVIDER AFFAIRS)
(313) 874-6764
Entity
Organization
Contact information
Practice address
47601 GRAND RIVER AVE, NOVI, MI 48374-1233
(248) 465-4170
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(248) 641-4041
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000001504A
CAPE
—
01
—
00277
BLUE CROSS
—
01
—
0061570
AETNA
—
01
—
100082
CARE CHOICE
—
01
—
1015800008
BOTSFORD
—
01
—
118635
GREAT LAKES
—
01
—
934000
BEAUMONT
—
01
—
HL630006
MCARE
—
01
—
M004776
TRICARE
—
Enumeration date
10/28/2005
Last updated
04/28/2026
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