Provider Demographics
NPI:1114202967
Name:SIGNATURE HOSPICE OF MICHIGAN, INC.
Entity Type:Organization
Organization Name:SIGNATURE HOSPICE OF MICHIGAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NISHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHFAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-620-4579
Mailing Address - Street 1:29400 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2320
Mailing Address - Country:US
Mailing Address - Phone:810-620-4579
Mailing Address - Fax:586-486-5976
Practice Address - Street 1:29400 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2320
Practice Address - Country:US
Practice Address - Phone:810-620-4579
Practice Address - Fax:586-486-5976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care