Healthcare Provider Details

I. General information

NPI: 1467174789
Provider Name (Legal Business Name): ANGELIC HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W UNIVERSITY DR SUITE A-4
ROCHESTER MI
48307-1817
US

IV. Provider business mailing address

900 W UNIVERSITY DR SUITE A-4
ROCHESTER MI
48307-1817
US

V. Phone/Fax

Practice location:
  • Phone: 586-991-1529
  • Fax: 586-991-5618
Mailing address:
  • Phone: 586-991-1529
  • Fax: 586-991-5618

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: ANGELYTH MARINO
Title or Position: PRESIDENT
Credential:
Phone: 586-276-5993