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Organization

W. A. FOOTE MEMORIAL HOSPITAL, INC.

Active
Other names
Henry Ford Jackson Hospital, Allegiance Health
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization

Contact information

Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4800
Mailing address
PO BOX 670884, DETROIT, MI 48267-2728
(800) 999-5829
(313) 876-1305

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
MI
103T00000X
Psychologist
104100000X
Social Worker
2084N0400X
Neurology Physician
2084P0800X
Psychiatry Physician
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260C863890
BCBSM
01
680C810300
BCBSM
MI
01
750910501
BCBSM
MI
01
800C810270
BCBSM
MI
01
CC5829
RR MEDICARE
MI
Enumeration date
07/03/2006
Last updated
04/07/2026
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