Provider Demographics
NPI:1730361858
Name:HEALTHSOURCE SAGINAW INC
Entity type:Organization
Organization Name:HEALTHSOURCE SAGINAW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PATIENT ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-790-7783
Mailing Address - Street 1:3340 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-9622
Mailing Address - Country:US
Mailing Address - Phone:989-790-7779
Mailing Address - Fax:989-964-5008
Practice Address - Street 1:3340 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-9622
Practice Address - Country:US
Practice Address - Phone:989-790-7779
Practice Address - Fax:989-964-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL8478112084P0800X
MI7300601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI750910806OtherBLUE CROSS BLUE SHIELD