Organization
MCLAREN BAY REGION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE C JACKS PORTER (VP/CFO)
(989) 894-3838
Entity
Organization
Contact information
Practice address
3250 E MIDLAND RD, BAY CITY, MI 48706-2835
(989) 894-3000
(989) 891-8172
Mailing address
1900 COLUMBUS AVE, BAY CITY, MI 48708-6831
(989) 894-3000
(989) 891-8172
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801860218
—
MI
01
—
23T041
MEDICARE PROVIDER NUMBER
MI
01
—
2778539
MEDICAID PROVIDER NUMBER
MI
Enumeration date
02/14/2006
Last updated
07/21/2020
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