Healthcare Provider Details

I. General information

NPI: 1962407486
Provider Name (Legal Business Name): COMMUNITY HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32932 WARREN RD STE 100
WESTLAND MI
48185-3095
US

IV. Provider business mailing address

32932 WARREN RD STE 100
WESTLAND MI
48185-3095
US

V. Phone/Fax

Practice location:
  • Phone: 734-522-4244
  • Fax: 734-522-2099
Mailing address:
  • Phone: 734-522-4244
  • Fax: 734-522-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number823511
License Number StateMI

VIII. Authorized Official

Name: MR. THOMAS J. LESONDAK
Title or Position: PRESIDENT
Credential:
Phone: 734-522-4244