Provider Demographics
NPI:1194771030
Name:ASCENSION BORGESS LEE HOSPITAL
Entity type:Organization
Organization Name:ASCENSION BORGESS LEE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-226-4800
Mailing Address - Street 1:1717 SHAFFER STREET
Mailing Address - Street 2:SUITE 002
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048
Mailing Address - Country:US
Mailing Address - Phone:269-552-2830
Mailing Address - Fax:
Practice Address - Street 1:420 WEST HIGH STREET
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1943
Practice Address - Country:US
Practice Address - Phone:269-782-8681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
MISFE1414003186282NC0060X
MI1060000082282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5171083Medicaid
MI1555987Medicaid
231315Medicare PIN
MI231315Medicare ID - Type Unspecified