Healthcare Provider Details

I. General information

NPI: 1306249073
Provider Name (Legal Business Name): WINGS OF HOPE HOSPICE AND PALLIATIVE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 LINN ST
ALLEGAN MI
49010-1562
US

IV. Provider business mailing address

530 LINN ST
ALLEGAN MI
49010-1562
US

V. Phone/Fax

Practice location:
  • Phone: 269-686-8659
  • Fax: 269-686-9643
Mailing address:
  • Phone: 269-686-8659
  • Fax: 269-686-9643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: THERESA LYNN
Title or Position: EXECUTIVE DIRECTOR
Credential: RN, LMSW
Phone: 269-686-8659