Provider Demographics
NPI:1083967855
Name:REVERENCE HOME HEALTH AND HOSPICE, INC
Entity Type:Organization
Organization Name:REVERENCE HOME HEALTH AND HOSPICE, INC
Other - Org Name:ASCENSION AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-658-2768
Mailing Address - Street 1:5445 ALI DR DEPT 800
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5195
Mailing Address - Country:US
Mailing Address - Phone:810-603-8600
Mailing Address - Fax:
Practice Address - Street 1:716 GERMAN ST
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9349
Practice Address - Country:US
Practice Address - Phone:989-362-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health