Provider Demographics
NPI:1083071823
Name:THE CASCADE PACE, INC.
Entity Type:Organization
Organization Name:THE CASCADE PACE, INC.
Other - Org Name:THOME PACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MM, LBSW
Authorized Official - Phone:517-768-9791
Mailing Address - Street 1:2282 SPRINGPORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1460
Mailing Address - Country:US
Mailing Address - Phone:517-768-9791
Mailing Address - Fax:517-783-5223
Practice Address - Street 1:2282 SPRINGPORT RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1460
Practice Address - Country:US
Practice Address - Phone:517-768-9791
Practice Address - Fax:517-783-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization