Healthcare Provider Details

I. General information

NPI: 1992331128
Provider Name (Legal Business Name): CARELINE HEALTH GROUP - MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W MICHIGAN AVE STE 1024TH
JACKSON MI
49201-1340
US

IV. Provider business mailing address

113 W MICHIGAN AVE STE 1024TH
JACKSON MI
49201-1340
US

V. Phone/Fax

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

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: JOSEPH DONALD MEAD
Title or Position: CEO
Credential:
Phone: 517-212-9000