Organization
ST MARY MERCY HOSPITAL PROFESSIONAL
Active
Parent organization
ST MARY MERCY HOSPITAL PROFESSIONAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST MARY MERCY HOSPITAL PROFESSIONAL
Authorized official
DAVID SPIVEY (PRESIDENT / CEO)
(734) 655-1610
Entity
Organization
Contact information
Practice address
2006 HOGBACK RD, SUITE 1, ANN ARBOR, MI 48105-9750
(734) 786-2300
(734) 786-4915
Mailing address
5301 E HURON RIVER DR, MC 69504, YPSILANTI, MI 48197-1051
(734) 827-8883
(734) 827-8822
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H10674
BCBSM PIN
—
Enumeration date
12/14/2011
Last updated
01/29/2016
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