Healthcare Provider Details
I. General information
NPI: 1962446237
Provider Name (Legal Business Name): HOSPICE OF MICHIGAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 S OTSEGO AVE
GAYLORD MI
49735-1776
US
IV. Provider business mailing address
2366 OAK VALLEY DR
ANN ARBOR MI
48103-8944
US
V. Phone/Fax
- Phone: 989-731-2744
- Fax:
- Phone: 989-358-4280
- 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:
LEE ANN
MYERS
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 734-718-5037