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General NPI Number Information
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NPI Number | 1962407486
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOSPICE, INC.
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32932 WARREN RD STE 100
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City | WESTLAND
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State | MI
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Zip | 48185-3095
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Country | US
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Telephone | 734-522-4244
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Fax | 734-522-2099
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Provider Business Mailing Address
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Address Line | 32932 WARREN RD STE 100
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City | WESTLAND
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State | MI
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Zip | 48185-3095
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Country | US
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Telephone | 734-522-4244
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Fax | 734-522-2099
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS J. LESONDAK
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Credential |
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Telephone | 734-522-4244
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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 | 823511
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License Number State | MI
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