Organization
W. A. FOOTE MEMORIAL HOSPITAL, INC
Active
Other names
Henry Ford Allegiance Health
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN LEONARD (VP FINANCE)
(517) 205-7843
Entity
Organization
Contact information
Practice address
2424 W WASHINGTON AVE STE 200, JACKSON, MI 49203-1236
(517) 205-4001
(517) 205-0126
Mailing address
PO BOX 67000 DEPT 272801, DETROIT, MI 48267-2728
(517) 205-7843
(517) 205-7419
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053403402
—
MI
Enumeration date
03/22/2018
Last updated
03/28/2018
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