Organization
STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Active
Other names
Kalamazoo Psychiatric Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
GORDY NORRIS (ADMINISTRATIVE MANAGER)
(269) 337-3048
Entity
Organization
Contact information
Practice address
1312 OAKLAND DR, KALAMAZOO, MI 49008-1205
(269) 337-3106
(269) 337-3121
Mailing address
1312 OAKLAND DR, KALAMAZOO, MI 49008-1205
(269) 337-3106
(269) 337-3121
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010C976460
BC PROVIDER #
MI
05
—
1954373
—
MI
01
—
260C976440
BC PROVIDER #
MI
01
—
480C961160
BC PROVIDER #
MI
Enumeration date
08/10/2006
Last updated
10/25/2022
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