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PACE OF SOUTHWEST MICHIGAN INC NPI 1568709392


NPI Information

NPI: 1568709392
Provider Name: PACE OF SOUTHWEST MICHIGAN INC
Classification: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization - 251T00000X
Entity Type: Organization

CLIA Number: 23D2034533

Address:
2900 LAKEVIEW AVE
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 408-4322
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PACE OF SOUTHWEST MICHIGAN INC is a program of all inclusive care for the elderly pace provider organization in Saint Joseph, MI. The provider is a PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. PACE OF SOUTHWEST MICHIGAN INC NPI is 1568709392. The provider is registered as an organization entity type.

The provider's business location address is:

2900 LAKEVIEW AVE
SAINT JOSEPH, MI
ZIP 49085-379
Phone: (269) 408-4322
Fax: (269) 408-4340

The provider's authorized official is Therese Saggau .
The authorized official title is Executive Director and has the following contact phone number (269) 408-4322.

The CLIA number assigned to this NPI record is 23D2034533 - other - pace clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/14/2013 and was last updated on 5/14/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251T00000XProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12331543MEDICAIDMICHIGAN
22332863OTHERMICHIGANMEDICAID BILLING AGENT ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.