NPIMap

Organization Active NPI

Havenwyck Hospital Inc

  • Psychiatric Hospital
  • Auburn Hills, MI
National Provider Identifier
1053342220
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
H-075/2006 Issued in MI
Legal business name
HAVENWYCK HOSPITAL INC
Practice address
1525 University Dr
Auburn Hills, MI 48326-2673
Phone
(248) 373-9200
Fax
(248) 373-4113
NPI assigned
Jul 6, 2006
Last updated
Mar 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steve Filton
Title
SRVP Cfo
Phone
(610) 768-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X H-075/2006 MI Primary

Addresses

Primary practice location

1525 University Dr
Auburn Hills, MI 48326-2673

Mailing address

1525 University Dr
Auburn Hills, MI 48326-2673
Phone (248) 373-9200

Other identifiers 2

IdentifierTypeStateIssuer
00106OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
170528921MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060829000351 MI Part A Provider - Hospital 5799697603 Practice locations: Auburn Hills, MI
O20170817000868 MI Part B Supplier - Clinic/Group Practice 5799697603 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Auburn Hills, MI; Saint Johns, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053342220. Details of each certification follow.

Hospital certification: CCN 234023

Legal name
HAVENWYCK HOSPITAL INC
Doing business as
HAVENWYCK HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 7, 1983
Last certification
Sep 30, 2015
Beds
120
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
May 15, 1980 in MI
Enrollment address
1525 University Dr
Auburn Hills, MI 48326-2673
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Havenwyck HospitalCCN 234023 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0371879Havenwyck Hospital1525 University Dr, Auburn Hills, MI 48326Certificate of waiverJul 6, 2027

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1525 University Dr
Auburn Hills, MI 48326
Phone (248) 371-2200

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michelle M Ouellette Individual Contracted Managing EmployeeCfo Oct 10, 2022
Corporate OfficerCfo Oct 10, 2022
Premier Behavioral Solutions, Inc. Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 29, 1982 100%
George H Brunner Individual Corporate OfficerAssistant Secretary Nov 15, 2010 100%
Jaime White Individual Contracted Managing EmployeeCeo Aug 1, 2022
Corporate OfficerCeo Aug 1, 2022
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Nov 15, 2010 100%
Matthew J Peterson Individual Corporate OfficerPresident Sep 19, 2019 100%
Corporate DirectorPresident Sep 19, 2019 33.3%
Operational/Managerial ControlPresident Sep 19, 2019 100%
Michigan Psychiatric Services, Inc Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 15, 1980 100%
Thomas M Day Individual Corporate OfficerVice President Jul 21, 2021 100%
Corporate DirectorVice President Jul 21, 2021 33.3%
Steve Filton Individual Corporate OfficerVice President & Board Member Nov 15, 2010 100%
Corporate DirectorVice President & Board Member Nov 15, 2010 33.3%
Operational/Managerial ControlVice President & Board Member Nov 15, 2010 100%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Nov 15, 2010 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 15, 2010 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Mar 14, 2014 50%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Management services company, Chain home office Operational/Managerial Control Nov 15, 2010 100%
Psychiatric Solutions, Inc. Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 15, 1983 100%
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChairman of the Board Mar 25, 2022 86.5%

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Metropolitan Behavioral HealthDearborn, MI, CCN 234045 Hospital 5% Or Greater Direct Ownership Interest (70%) Sep 21, 2018
Southridge Behavioral HospitalByron Center, MI, CCN 234052 Hospital 5% Or Greater Direct Ownership Interest (51%) May 28, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 172

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 172

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1053342220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 UNIVERSITY DR",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262673",
            "telephone_number": "248-373-9200",
            "fax_number": "248-373-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 UNIVERSITY DR",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262673",
            "telephone_number": "248-373-9200",
            "fax_number": "248-373-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENWYCK HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SRVP CFO",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MI",
            "license": "H-075/2006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "00106",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170528921",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

Verify at the official NPI Registry.