Provider Demographics
NPI:1124017538
Name:HOSPICE ADVANTAGE, LLC.
Entity Type:Organization
Organization Name:HOSPICE ADVANTAGE, LLC.
Other - Org Name:HOME ADVANTAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDEBRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-894-9114
Mailing Address - Street 1:401 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5962
Mailing Address - Country:US
Mailing Address - Phone:989-894-9114
Mailing Address - Fax:989-894-9118
Practice Address - Street 1:401 CENTER AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5962
Practice Address - Country:US
Practice Address - Phone:989-894-9114
Practice Address - Fax:989-894-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E972OtherBCBS OF MICHIGAN
MI01003151OtherHEALTH PLUS OF MICHIGAN
MI4791502Medicaid
MI4791502Medicaid