Healthcare Provider Details

I. General information

NPI: 1770257818
Provider Name (Legal Business Name): CARELINE HMI300 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 KENMOOR AVE SE STE 100
GRAND RAPIDS MI
49546-8602
US

IV. Provider business mailing address

801 ROSEHILL RD
JACKSON MI
49202-1762
US

V. Phone/Fax

Practice location:
  • Phone: 517-212-2006
  • Fax: 517-212-2007
Mailing address:
  • Phone: 517-212-9000
  • Fax: 517-212-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH D MEAD
Title or Position: CEO
Credential: JD, MBA
Phone: 517-212-2006