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General NPI Number Information
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NPI Number | 1962019141
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Entity Type | Organization
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Legal Business Name | COMPASSUS AAH OF MICHIGAN IV, LLC
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/30/2020
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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 | 810-344-8396
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Fax | 844-552-6192
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Provider Business Mailing Address
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Address Line | 10 CADILLAC DR STE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-1001
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Country | US
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Telephone | 417-841-4834
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Fax | 866-955-8538
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Authorized Official
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Title or Position | SVP GENERAL COUNSEL
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Name | RUSSELL ADKINS
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Credential |
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Telephone | 615-309-5668
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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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