Provider Demographics
NPI:1871518019
Name:ASCENSION BORGESS ALLEGAN HOSPITAL
Entity type:Organization
Organization Name:ASCENSION BORGESS ALLEGAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-570-5704
Mailing Address - Street 1:551 LINN ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-1595
Mailing Address - Country:US
Mailing Address - Phone:269-686-4110
Mailing Address - Fax:269-686-2135
Practice Address - Street 1:551 LINN ST
Practice Address - Street 2:SUITE 230
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1595
Practice Address - Country:US
Practice Address - Phone:269-686-4110
Practice Address - Fax:269-686-2135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION ALLEGAN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-12
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Z36010OtherBCBSM
MI0Z36010Medicare PIN