NPIMap

Organization Active NPI

W. a. Foote Memorial Hospital, Inc

Doing business as Henry Ford Allegiance Health

  • Substance Abuse Rehabilitation Facility
  • Jackson, MI
National Provider Identifier
1750885703
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
W. A. FOOTE MEMORIAL HOSPITAL, INC
Doing business as
Henry Ford Allegiance Health
Practice address
2424 W Washington Ave Ste 200
Jackson, MI 49203-1236
Phone
(517) 205-4001
Fax
(517) 205-0126
NPI assigned
Mar 22, 2018
Last updated
Mar 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Authorized official

Name
Kevin Leonard
Title
VP Finance
Phone
(517) 205-7843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2424 W Washington Ave Ste 200
Jackson, MI 49203-1236

Mailing address

PO Box 67000 Dept 272801
Detroit, MI 48267-2728
Phone (517) 205-7843

Other identifiers 1

IdentifierTypeStateIssuer
1053403402MedicaidMI

Other names 1

  • Henry Ford Allegiance Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Foote HLTH Ctr Pha104 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2424 W Washington Ave
Ste 200
Jackson, MI 49203
Phone (517) 205-2736

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1750885703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000 DEPT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-205-7843",
            "fax_number": "517-205-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 W WASHINGTON AVE STE 200",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031236",
            "telephone_number": "517-205-4001",
            "fax_number": "517-205-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. A. FOOTE MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "517-205-7843"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053403402",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Ford Allegiance Health",
            "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 Mar 28, 2018; 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.