Healthcare Provider Details
I. General information
NPI: 1376200121
Provider Name (Legal Business Name): CARELINE HMI400 LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2021
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24255 W 13 MILE RD STE 210
BINGHAM FARMS MI
48025-4327
US
IV. Provider business mailing address
801 ROSEHILL RD
JACKSON MI
49202-1762
US
V. Phone/Fax
- Phone: 517-212-2006
- Fax:
- Phone: 517-212-9000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
DONALD
MEAD
Title or Position: CEO
Credential:
Phone: 517-212-9000