Provider Demographics
NPI:1114014305
Name:THI OF MICHIGAN AT DETROIT, LLC
Entity Type:Organization
Organization Name:THI OF MICHIGAN AT DETROIT, LLC
Other - Org Name:HOSPICE COMPASSUS - DETROIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-309-5668
Mailing Address - Street 1:10 CADILLAC DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5078
Mailing Address - Country:US
Mailing Address - Phone:615-425-5407
Mailing Address - Fax:615-373-4457
Practice Address - Street 1:30665 NORTHWESTERN HIGHWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-355-9900
Practice Address - Fax:248-355-5705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4596778Medicaid
MI4596778Medicaid