MEDICARE: ACCELERATED HOSPICE CARE SERVCIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1144990714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCELERATED HOSPICE CARE SERVCIES, INC

Provider Business Mailing Address
First Line	:	17520 W 12 MILE RD STE 102
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1943
Country	:	US
Telephone Number	:	248-281-6880
Fax Number	:	248-281-6871

Provider Business Practice Location Address
First Line	:	17520 W 12 MILE RD STE 102
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1943
Country	:	US
Telephone Number	:	248-281-6880
Fax Number	:	248-281-6871

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ADELINA BASTE MCCAULLEY
Credential	:	REGISTERED NURSE
Telephone Number	:	248-281-6880

Provider Enumeration Date	:	09/15/2021
Last Update Date	:	09/15/2021

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