MEDICARE: OHC OF SE MICHIGAN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1134080443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHC OF SE MICHIGAN LLC

Provider Business Mailing Address
First Line	:	14930 LAPLAISANCE RD STE 115
Second Line	:
City	:	MONROE
State	:	MI
Zip	:	48161-3871
Country	:	US
Telephone Number	:	419-873-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	14930 LAPLAISANCE RD STE 115
Second Line	:
City	:	MONROE
State	:	MI
Zip	:	48161-3871
Country	:	US
Telephone Number	:	419-873-6000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOSHUA A ADAMS
Credential	:
Telephone Number	:	419-843-4422

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	11/18/2025

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