MEDICARE: 1ST CALL HOSPICE CARE 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	:	1558136895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST CALL HOSPICE CARE LLC

Provider Business Mailing Address
First Line	:	22367 STARKS DR
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48036-1197
Country	:	US
Telephone Number	:	586-782-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	22367 STARKS DR
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48036-1197
Country	:	US
Telephone Number	:	586-782-6363
Fax Number	:

Authorized Official
Title or Position	:	OWNER / OPERATOR
Name	:	MR. JASON GROTH
Credential	:
Telephone Number	:	586-709-2314

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	09/11/2024

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