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General NPI Number Information
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NPI Number | 1114202967
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Entity Type | Organization
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Legal Business Name | SIGNATURE HOSPICE OF MICHIGAN, INC.
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 29400 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-2320
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Country | US
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Telephone | 810-620-4579
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Fax | 586-486-5976
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Provider Business Mailing Address
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Address Line | 29400 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48093-2320
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Country | US
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Telephone | 810-620-4579
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Fax | 586-486-5976
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | NISHAT ASHFAQ
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Credential |
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Telephone | 810-620-4579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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