Organization
LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM CALHOUN (CFO/VP OF FINANCE)
(269) 983-8398
Entity
Organization
Contact information
Practice address
6418 DEANS HILL RD, BERRIEN CENTER, MI 49102-9750
(269) 473-3003
(269) 473-3010
Mailing address
PO BOX 800, SAINT JOSEPH, MI 49085-0800
(269) 428-2574
(269) 428-0490
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
113010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4164932
—
MI
01
—
S9516
BLUE CROSS
—
Enumeration date
07/17/2006
Last updated
06/03/2008
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