Organization
SELECT SPECIALTY HOSPITAL - NORTHWEST DETROIT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E. TARVIN (VICE PRESIDENT)
(717) 972-1100
Entity
Organization
Contact information
Practice address
6071 W OUTER DR, 7TH FLOOR, DETROIT, MI 48235-2624
(313) 966-4797
(313) 966-6137
Mailing address
4714 GETTYSBURG RD, LEGAL DEPT., MECHANICSBURG, PA 17055-4325
(717) 972-1100
(717) 975-9981
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
830523
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09325
BCBS MI
MI
Enumeration date
07/26/2005
Last updated
09/02/2010
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