NPIMap

Organization Active NPI

LTAC Hospital Detroit, LLC

  • General Acute Care Hospital
  • Detroit, MI
National Provider Identifier
1669400305
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
B30526 Issued in MI
Legal business name
LTAC HOSPITAL DETROIT, LLC
Practice address
801 Virginia Park St
Third Floor
Detroit, MI 48202-1925
Phone
(313) 870-9870
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Alan Fisher
Title
Ceo/President
Phone
(313) 870-9870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X B30526 MI Primary

Addresses

Primary practice location

801 Virginia Park St
Third Floor
Detroit, MI 48202-1925

Mailing address

801 Virginia Park St
Third Floor
Detroit, MI 48202-1925

Other identifiers 1

IdentifierTypeStateIssuer
830526OtherMIST. LIC. NO.

National Provider Directory

National Provider Directory
Tax ID family
LTAC Hospital Detroit2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669400305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 VIRGINIA PARK ST",
            "address_2": "THIRD FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 VIRGINIA PARK ST",
            "address_2": "THIRD FLOOR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021925",
            "telephone_number": "313-870-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTAC HOSPITAL DETROIT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "313-870-9870"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "B30526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST. LIC. NO.",
            "identifier": "830526",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.