NPIMap

Organization Active NPI

Jackson-Hillsdale Community Mental Health Board

  • Community/Behavioral Health Agency
  • Jackson, MI
National Provider Identifier
1265795694
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JACKSON-HILLSDALE COMMUNITY MENTAL HEALTH BOARD
Practice address
1200 N West Ave
Jackson, MI 49202-2179
Phone
(517) 780-3332
Fax
(517) 796-4532
NPI assigned
Jun 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Authorized official

Name
Ms. Maribeth Caldwell
Title
Chief Executive Officer
Phone
(517) 789-1208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1200 N West Ave
Jackson, MI 49202-2179

Mailing address

1200 N West Ave
Jackson, MI 49202-2179
Phone (517) 780-3332

Other identifiers 1

IdentifierTypeStateIssuer
1712229MedicaidMI

Other names 1

  • LIFEWAYS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jackson Hillside CMH6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1265795694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3332",
            "fax_number": "517-796-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3332",
            "fax_number": "517-796-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON-HILLSDALE COMMUNITY MENTAL HEALTH BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "MARIBETH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "517-789-1208",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712229",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFEWAYS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.