W.A. FOOTE MEMORIAL HOSPITAL, INC. (NPI# 1598857948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598857948 |
| Entity Type | Organization |
| Organization Name | W.A. FOOTE MEMORIAL HOSPITAL, INC. |
| Other Organization Name | HENRY FORD ALLEGIANCE SUBSTANCE ABUSE SERVICES |
| Practice Address |
205 N. East Ave 7th Fl One Jackson Square Jackson MI 49201 |
| Practice Telephone | 5177884713 |
| Practice Fax Number | 5178417419 |
| Mailing Telephone | 5177884713 |
| Mailing Fax Number | 5178417419 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2016-04-01 |
| Authorized Official Name | MRS. JEANNE' WICKENS (SR. VICE PRESIDENT, FINANCE CFO) |
| Authorized Official Telephone | 5177886979 |
| Is Organization Subpart | Y |
| Parent Organization Name | W.A. FOOTE MEMORIAL HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PREFERRED CARE CHOICES | P100094 | 01 |
| MI | UNITED MINE WORKERS | 030066700 | 01 |
| KY | 01410125 | 05 | |
| MI | BLUE CROSS OF MICHIGAN | 20081 | 01 |
| MI | BLUE CARE NETWORK | 00080 | 01 |
| FL | 092063100 | 05 | |
| OH | 2855754 | 05 | |
| MI | PHYSICIAN'S HEALTH PLAN | 5020010 | 01 |
| MI | MCARE | HL380002 | 01 |
| MI | PREFERRED CHOICES | 100094 | 01 |
| MI | HEALTH ALLIANCE PLAN | 045908 | 01 |
| Other Name | Type Code |
|---|---|
| Henry Ford Allegiance Substance Abuse Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669569034 | W.a. Foote Memorial Hospital, Inc. | Durable Medical Equipment & Medical Supplies | 700 E Michigan Ave, Jackson, MI 49201-1626 | 2006-10-06 |
| 1780776138 | W.a. Foote Memorial Hospital, Inc. | Clinic/Center | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| 1598203655 | W.a. Foote Memorial Hospital, Inc. | Internal Medicine | 205 N. East Ave., Jackson, MI 49201 | 2017-02-08 |
| 1831599224 | W.a. Foote Memorial Hospital, Inc. | In Home Supportive Care | 1 S Jackson Sq, 4th Floor, Jackson, MI 49201-1457 | 2014-09-04 |
| 1437235298 | W.a. Foote Memorial Hospital, Inc. | Pharmacist | 205 N East Ave, Jackson, MI 49201-1753 | 2006-10-27 |
| 1710063276 | W.a. Foote Memorial Hospital, Inc. | Pharmacy | 2200 Springport Rd, Jackson, MI 49202-1432 | 2006-10-27 |
| 1962586123 | W.a. Foote Memorial Hospital, Inc. | Home Health | 205 N East Ave, One Jackson Square, Suite 400, Jackson, MI 49201-1753 | 2006-10-24 |
| 1700968211 | W.a. Foote Memorial Hospital, Inc. | Pharmacist | 2200 Springport Rd, Jackson, MI 49202-1432 | 2006-10-20 |
| 1265528939 | W.a. Foote Memorial Hospital, Inc. | General Acute Care Hospital | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-10-04 |
| 1407948854 | W.a. Foote Memorial Hospital, Inc. | Rehabilitation, Substance Use Disorder Unit | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| Street Address |
205 N. EAST AVE 7TH FL ONE JACKSON SQUARE |
| City | JACKSON |
| State | MI |
| Zip Code | 49201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780776138 | W.a. Foote Memorial Hospital, Inc. | Clinic/Center | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| 1528620366 | Maha Mahesh Bayya | Student in an Organized Health Care Education/Training Program | 205 N. East Ave, Gme - 2nd Floor Cab, Jackson, MI 49201-1753 | 2019-07-02 |
| 1558856187 | Narine Shirvanian | Student in an Organized Health Care Education/Training Program | 205 N. East Ave, 2nd Floor Anderson Building, Jackson, MI 49201 | 2018-06-26 |
| 1255861241 | Michael Doyle | Student in an Organized Health Care Education/Training Program | 205 N. East Ave, Jackson, MI 49201 | 2017-06-13 |
| 1073051199 | W.a. Foote Memorial Hospital, Inc | Hospitalist | 205 N. East Ave, Attn: Provider Enrollment, Jackson, MI 49201 | 2017-02-09 |
| 1912445677 | W.a. Foote Memorial Hospital, Inc | Psychiatry & Neurology | 205 N. East Ave, Jackson, MI 49201 | 2017-02-02 |
| 1134666936 | W.a. Foote Memorial Hospital, Inc | Dermatology | 205 N. East Ave, Jackson, MI 49201 | 2017-01-31 |
| 1538606348 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-31 |
| 1891232740 | W.a. Foote Memorial Hospital, Inc | Pediatrics | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1356888218 | W.a. Foote Memorial Hospital, Inc | Internal Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407948854 | W.a. Foote Memorial Hospital, Inc. | Rehabilitation, Substance Use Disorder Unit | 205 N. East Ave, 7th Fl One Jackson Square, Jackson, MI 49201 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821311341 | Peer Choices, Inc. | Rehabilitation, Substance Use Disorder Unit | 255 N Telegraph Rd Ste 206, Waterford, MI 48328-3355 | 2010-03-11 |
| 1174720080 | St Joseph Mercy Hospital | Rehabilitation, Substance Use Disorder Unit | 5401 Mcauley Drive, Ypsilanti, MI 48197-1011 | 2007-07-03 |
| 1235749219 | Joel Darnell Dewberry | Rehabilitation, Substance Use Disorder Unit | 20102 Harper Ave, Harper Woods, MI 48225-1712 | 2020-08-05 |
| 1417570128 | Sheridan Community Hospital | Rehabilitation, Substance Use Disorder Unit | 301 N Main St, Sheridan, MI 48884-9235 | 2020-05-28 |
| 1417589086 | Black Rock Recovery, LLC | Rehabilitation, Substance Use Disorder Unit | 25235 Orchard Lake Rd, Farmington Hills, MI 48336-1233 | 2020-02-11 |
| 1053722280 | Eagle Advancement Institute | Rehabilitation, Substance Use Disorder Unit | 7091 Orchard Lake Rd, Suite 200, West Bloomfield, MI 48322-3654 | 2014-05-09 |
| 1174871305 | Dlp Marquette General Hospital LLC | Rehabilitation, Substance Use Disorder Unit | 420 W Magnetic St, Marquette, MI 49855-2700 | 2012-08-20 |
| 1932363454 | Munson Medical Center | Rehabilitation, Substance Use Disorder Unit | 1105 6th St, Traverse City, MI 49684-2345 | 2008-07-14 |
| 1487817680 | Alpena Regional Medical Center-bhs | Rehabilitation, Substance Use Disorder Unit | 1501 W Chisholm St, Alpena, MI 49707-1401 | 2008-07-08 |
| 1598949794 | Healthsource Saginaw Inc | Rehabilitation, Substance Use Disorder Unit | 3340 Hospital Rd, Saginaw, MI 48603-9622 | 2007-12-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.