Organization
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Active
Other names
Sparrow Behavioral Health Services, University of Michigan Health-Sparrow St. Lawrence
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY RUSSIAN (SUPERVISOR, PROVIDER ENROLLMENT)
(517) 253-6308
Entity
Organization
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-7700
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-6000
(517) 364-6009
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
PH-040/2005(2)
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025
BLUE CROSS/BCN
MI
01
—
200000000005
PHP FAMILY CARE
MI
05
—
30-1557293
—
MI
Enumeration date
03/22/2006
Last updated
02/28/2024
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