Provider Demographics
NPI:1073906590
Name:COMMUNITY HEALTH HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH HOSPICE CARE, LLC
Other - Org Name:COMMUNITY HEALTH HOSPICE CARE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LAING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-834-2672
Mailing Address - Street 1:30600 NORTHWESTERN HWY STE 245
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3171
Mailing Address - Country:US
Mailing Address - Phone:833-483-2273
Mailing Address - Fax:
Practice Address - Street 1:30600 NORTHWESTERN HWY STE 245
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3171
Practice Address - Country:US
Practice Address - Phone:833-483-2273
Practice Address - Fax:248-479-8126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041000151251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based