Organization
HENRY FORD MACOMB HOSPITAL CORPORATION
Active
Other names
Henry Ford Macomb Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY GOODBALIAN (REGIONAL VP FINANCE, CFO)
(586) 263-2705
Entity
Organization
Contact information
Practice address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(586) 263-2705
Mailing address
215 NORTH AVE, MOUNT CLEMENS, MI 48043-1716
(586) 263-2705
(586) 263-2255
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20315
BCBS OP SUBSTANCE ABUSE
MI
Enumeration date
11/26/2007
Last updated
12/30/2010
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