NPIMap

Organization Active NPI

Mymichigan Medical Center Sault

Doing business as War Memorial Behavorial Center

  • Psychiatric Hospital Unit
  • Kincheloe, MI
National Provider Identifier
1629260203
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
170020 Issued in MI
Legal business name
MYMICHIGAN MEDICAL CENTER SAULT
Doing business as
War Memorial Behavorial Center
Practice address
16523 S Water Tower Dr
Kincheloe, MI 49788-1592
Phone
(906) 495-4351
NPI assigned
Aug 16, 2007
Last updated
Feb 27, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Authorized official

Name
Sarah James
Title
Manager, Provider Enrollment
Phone
(989) 701-4734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 170020 MI Primary

Addresses

Primary practice location

16523 S Water Tower Dr
Kincheloe, MI 49788-1592

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Other names 1

  • War Memorial Behavorial Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071002000653 MI Part A Provider - Hospital 7315936481 Practice locations: Kincheloe, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629260203. Details of each certification follow.

Hospital certification: CCN 23S239

Legal name
MYMICHIGAN MEDICAL CENTER SAULT
Organization structure
CorporationNon-profit
Enrollment address
16523 S Water Tower Dr
Kincheloe, MI 49788-1592
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 12

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

National Provider Directory

National Provider Directory
Tax ID family
War Memorial Hospital C32 organizations share this tax ID, including this one
Part of
War Memorial Hospital C

Other organizations with this tax ID 31

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

View all 31

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
Holly Kibble Individual Corporate Officer Jan 1, 2017
Charles Palmer Individual Corporate OfficerBoard Member Jul 1, 2023
Sarah James Individual Corporate DirectorManager of Operations, Pe Jul 1, 2025
Ralph J Duman Individual Corporate OfficerBoard Member Jul 1, 2023
Amy Goetz Individual Corporate OfficerBoard Member Jul 1, 2023
Thomas Coates Individual Corporate OfficerBoard Member Jul 1, 2023
Kyle P Raycraft Individual Corporate Officer Jul 1, 2023
Lydia Watson Individual Corporate OfficerMymichigan Health Ceo Jul 1, 2023
Mark Savoie Individual Corporate OfficerBoard Member Jul 1, 2023
Jamie Devine Adair Individual Corporate OfficerBoard Member Jul 1, 2023
Samantha Hunter Individual W-2 Managing Employee Sep 11, 2023
Kevin R Kalchik Individual Corporate Director Mar 1, 2004
W-2 Managing Employee Mar 1, 2004
Tina Church Individual Corporate Director Sep 11, 2023
Mymichigan Health Organization, Midland, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022 100%
Maxine Anderson Individual Corporate Officer Jan 1, 2017
Nicole Oliver Individual Corporate OfficerBoard Member Jul 1, 2023

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Mymichigan Primary Care DrummondDrummond Island, MI, CCN 238767 Rural health clinic Operational/Managerial Control (100%) Aug 24, 2023

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 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1629260203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16523 S WATER TOWER DR",
            "city": "KINCHELOE",
            "state": "MI",
            "postal_code": "497881592",
            "telephone_number": "906-495-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER SAULT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2007-08-16",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "989-701-4734"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MI",
            "license": "170020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "War Memorial Behavorial Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kincheloe, MI

Sources for this page

Verify at the official NPI Registry.