Healthcare Provider Details

I. General information

NPI: 1649133224
Provider Name (Legal Business Name): PARC HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31690 W 12 MILE RD STE 102
FARMINGTON HILLS MI
48334-4404
US

IV. Provider business mailing address

31690 W 12 MILE RD STE 102
FARMINGTON HILLS MI
48334-4404
US

V. Phone/Fax

Practice location:
  • Phone: 248-328-2939
  • Fax: 248-328-2941
Mailing address:
  • Phone: 248-328-2939
  • Fax: 248-328-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN GASSO
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 248-328-2939