Healthcare Provider Details

I. General information

NPI: 1851187652
Provider Name (Legal Business Name): EMMANUEL HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HALL ST SW STE 263
GRAND RAPIDS MI
49503-4988
US

IV. Provider business mailing address

401 HALL ST SW STE 263
GRAND RAPIDS MI
49503-4988
US

V. Phone/Fax

Practice location:
  • Phone: 616-719-0919
  • Fax: 616-719-0933
Mailing address:
  • Phone: 616-719-0919
  • Fax: 616-719-0933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SARA TORREY LOWE
Title or Position: EXECUTIVE DIRECTOR
Credential: LMSW
Phone: 616-719-0919