Provider Demographics
NPI:1265426704
Name:HEALTHSOURCE SAGINAW INC
Entity type:Organization
Organization Name:HEALTHSOURCE SAGINAW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PATIENT ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-790-7783
Mailing Address - Street 1:3340 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-9622
Mailing Address - Country:US
Mailing Address - Phone:989-790-7700
Mailing Address - Fax:989-790-7297
Practice Address - Street 1:3340 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-9622
Practice Address - Country:US
Practice Address - Phone:989-790-7700
Practice Address - Fax:989-790-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0401X
MIH026/2001(2)273R00000X
MI730060273Y00000X
MI730034276400000X
MI733010313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No273R00000XHospital UnitsPsychiatric Unit
No273Y00000XHospital UnitsRehabilitation Unit
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICD4197OtherPALMETTO GBA RAILROAD MEDICARE
MICE4327OtherPALMETTO GBA RAILROAD MEDICARE
MI302775288Medicaid
MICE4324OtherPALMETTO GBA RAILROAD MEDICARE
MI405171780Medicaid
MI00237OtherBCBS HOSPITAL UNITS
MI622805206Medicaid
MICE4328OtherPALMETTO GBA RAILROAD MEDICARE
MI00237OtherBCBS HOSPITAL UNITS
MICE4324OtherPALMETTO GBA RAILROAD MEDICARE
MI622805206Medicaid
MI0M15400Medicare PIN
MICE4328OtherPALMETTO GBA RAILROAD MEDICARE
MI302775288Medicaid
MI23T275Medicare Oscar/Certification
MI0N26340Medicare PIN