Organization
MERCY MEMORIAL HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY CSOKASY LMSW (MENTAL HEALTH SERVICES DIRECTOR)
(734) 240-1770
Entity
Organization
Contact information
Practice address
700 STEWART RD, STE 105, MONROE, MI 48162-5304
(734) 240-1770
(734) 240-1780
Mailing address
718 N MACOMB ST, MONROE, MI 48162
(734) 240-8400
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
580030
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029203
VAL OPTS
MI
01
—
03533
PARAMOUNT
MI
01
—
20060
BC UB
MI
01
—
4597597
AETNA
MI
01
—
750910950
BC 1500
MI
Enumeration date
01/22/2007
Last updated
04/28/2009
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