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NPI Code Detail

MEDICARE: HOSPICE AT HOME, INC.

MEDICARE: HOSPICE AT HOME, INC.
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
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11831186311OTHERMINPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316364383
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOSPICE AT HOME, INC.
Provider Business Mailing Address
First Line : 4025 HEALTH PARK LN
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-3421
Country : US
Telephone Number : 269-429-7100
Fax Number : 269-429-1307
Provider Business Practice Location Address
First Line : 4025 HEALTH PARK LN
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-3421
Country : US
Telephone Number : 269-429-7100
Fax Number : 269-429-1307
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : DANIEL WASSENHOVE
Credential :
Telephone Number : 269-429-7100
Provider Enumeration Date : 03/27/2014
Last Update Date : 08/16/2023

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Directions to “HOSPICE AT HOME, INC. ” Practice Location

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