Provider Demographics
NPI:1508883299
Name:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Entity Type:Organization
Organization Name:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Other - Org Name:WALTER P. REUTHER PSYCHIATRIC HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOSPITAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY CLARE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-367-8401
Mailing Address - Street 1:1312 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1205
Mailing Address - Country:US
Mailing Address - Phone:269-337-3000
Mailing Address - Fax:269-337-3007
Practice Address - Street 1:30901 PALMER RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5389
Practice Address - Country:US
Practice Address - Phone:734-367-8576
Practice Address - Fax:734-722-6891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301001649283Q00000X
283Q00000X, 333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI160H211210OtherBCBSM GR# OBGYN
MI110Q262600OtherBCBSM GR # INTERNIST
MI1758872Medicaid
MI260Q262590OtherBCBSM GR# PSYCHIATRIST
MI480H278300OtherBCBSM GR# PODIATRY
MI010Q262580OtherBCBSM GR# INTERNIST
MI260Q262590OtherBCBSM GR# PSYCHIATRIST