Organization
CHILDRENS HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH SCALLON VICE PRESIDENT (VICE PRESIDENT FINANCE)
(313) 578-8564
Entity
Organization
Contact information
Practice address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 578-2564
(313) 578-3964
Mailing address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 578-2564
(313) 578-3964
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G41064
BCBSM PROVIDER NUMBER
MI
01
—
0H22264
BCBSM PROVIDER NUMBER
MI
Enumeration date
06/13/2007
Last updated
08/22/2020
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