Provider Demographics
NPI:1598786279
Name:HNERY FORD HEALTH SYSTEM DETROIT CENTER
Entity Type:Organization
Organization Name:HNERY FORD HEALTH SYSTEM DETROIT CENTER
Other - Org Name:HENRY FORD HEALTH SYSTEM
Other - Org Type:Other Name
Authorized Official - Title/Position:EVP, CHIEF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMSCHRODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-648-7204
Mailing Address - Street 1:1 FORD PL
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:313-874-3094
Mailing Address - Fax:313-874-6650
Practice Address - Street 1:1 FORD PL
Practice Address - Street 2:SUITE 1C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3450
Practice Address - Country:US
Practice Address - Phone:313-874-3094
Practice Address - Fax:313-874-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder