Organization
HENRY FORD HEALTH SYSTEM
Active
Parent organization
YES
Other names
Henry Ford Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
YES
Authorized official
MR. TIMOTHY LEROY HAYES FNP BC (NURSE PRACTITIONER)
(313) 916-2710
Entity
Organization
Contact information
Practice address
2799 WG BLVD, DETROIT, MI 48202
(313) 916-2710
Mailing address
826 EDISON ST, DETROIT, MI 48202-1537
(313) 869-2644
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
364707768
MEDICAID & MEDICARE
MI
Enumeration date
02/05/2010
Last updated
02/05/2010
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