Provider Demographics
NPI:1164404950
Name:HACKLEY VISITING NURSE SERVICES AND HOSPICE INC
Entity Type:Organization
Organization Name:HACKLEY VISITING NURSE SERVICES AND HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-542-8213
Mailing Address - Street 1:888 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1220
Mailing Address - Country:US
Mailing Address - Phone:231-726-5025
Mailing Address - Fax:231-728-4958
Practice Address - Street 1:888 TERRACE ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1220
Practice Address - Country:US
Practice Address - Phone:231-726-5025
Practice Address - Fax:231-728-4958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E026OtherBLUE CROSS & BLUE SHIELD
MI30937OtherHEALTH PLAN OF MICHIGAN
MI5173758Medicaid
MI0E026OtherBLUE CHOICE
MI0E026OtherBLUE CARE NETWORK
MI800000029OtherPRIORITY HEALTH
MI5173758Medicaid