Provider Demographics
NPI:1881610327
Name:HACKLEY HOSPITAL
Entity type:Organization
Organization Name:HACKLEY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEESSIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-728-4023
Mailing Address - Street 1:1675 LEAHY ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-5500
Mailing Address - Country:US
Mailing Address - Phone:231-728-4915
Mailing Address - Fax:231-728-5980
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-728-4915
Practice Address - Fax:231-728-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine