| NPI | 1003892092 |
|---|---|
| Former Legal Business Name | PROVIDENCE-PROVIDENCE PARK HOSPITAL |
| Entity Type | Organization |
| Authorized Contact | ROBIN DAMSCHRODER President, Val Based Ent &CFO 313-876-8452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273R00000X Psychiatric Unit |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2025-09-24 |