NPIMap

Organization Active NPI

Prime Healthcare Services - Garden City, LLC

  • Psychiatric Hospital Unit
  • Garden City, MI
National Provider Identifier
1407480247
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
PRIME HEALTHCARE SERVICES - GARDEN CITY, LLC
Practice address
6245 Inkster Rd
Garden City, MI 48135-4001
Phone
(734) 458-4421
NPI assigned
Mar 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

6245 Inkster Rd
Garden City, MI 48135-4001

Mailing address

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-4421

Other identifiers 1

IdentifierTypeStateIssuer
00006OtherMIBCBS OF MICHIGAN

Other names 1

  • Garden City Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200407002871 MI Part A Provider - Hospital 6800013459 Practice locations: Garden City, MI

Hospital certification: CCN 23S244

Legal name
PRIME HEALTHCARE SERVICES - GARDEN CITY LLC
Doing business as
GARDEN CITY HOSPITAL
Organization structure
LLCProprietary
Enrollment address
6245 Inkster Rd
Garden City, MI 48135-4001
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare SVS LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation 5% Or Greater Direct Ownership Interest Jul 1, 2014 100%
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Mar 30, 2020
Saju T George Individual Corporate OfficerChief Executive Officer Aug 1, 2013
Corporate DirectorDirector Aug 1, 2013
W-2 Managing EmployeeChief Executive Officer Aug 1, 2013
Prime Healthcare Holdings Inc Organization, Ontario, CA Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2014 100%

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
United Home Health Services Inc.Garden City, MI, CCN 237144 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2014
Jul 1, 2014

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 77

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

View all 77

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1407480247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - GARDEN CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "00006",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden City Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.