| Organization Name: | PROVIDENCE HOSPITAL |
| NPI Number: | 1548486681 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VIJAY MITTAL (PROGRAM DIRECTOR) |
| Mailing Address: | 10508 Keane Dr Grass Lake |
| State: | MI US |
| Postal Code: | 492408803 |
| Phone Number: | 5175224451 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282N00000X |
| License Number: | L952723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |