Organization
SAINT JOSEPH MERCY LIVINGSTON HOSPITAL
Active
Parent organization
TRINITY HEALTH - MICHIGAN
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRINITY HEALTH - MICHIGAN
Authorized official
MICHAEL GUSHO (SE MI REGIONAL C.F.O.)
(734) 398-0642
Entity
Organization
Contact information
Practice address
2300 GENOA BUSINESS PARK DR, SUITE 180, BRIGHTON, MI 48114-7367
(810) 844-7300
Mailing address
34505 W 12 MILE RD, SUITE 200, FARMINGTON HILLS, MI 48331-3258
(734) 343-3923
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10435
BLUE CROSS
MI
Enumeration date
05/08/2007
Last updated
01/13/2017
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