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General NPI Number Information
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NPI Number | 1598018673
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Entity Type | Organization
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Legal Business Name | REVERENCE HOME HEALTH AND HOSPICE, INC
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 07/29/2019
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Provider Practice Location Address
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Address Line | 5445 ALI DR DEPT 600
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City | GRAND BLANC
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State | MI
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Zip | 48439-5195
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Country | US
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Telephone | 810-603-8675
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Fax | 810-603-8661
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Provider Business Mailing Address
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Address Line | PO BOX 780598
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City | PHILADELPHIA
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State | PA
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Zip | 19178-0598
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Country | US
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Telephone | 810-603-8675
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Fax |
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Authorized Official
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Title or Position | VP REVENUE CYCLE
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Name | STEVEN SCOTT
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Credential |
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Telephone | 408-658-2768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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