Provider Demographics
NPI:1407308026
Name:INTELICARE HOSPICE SERVICES II, LLC
Entity Type:Organization
Organization Name:INTELICARE HOSPICE SERVICES II, LLC
Other - Org Name:THE CARE TEAM HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:DEWBRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-534-0716
Mailing Address - Street 1:6170 US HIGHWAY 31 N UNIT B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49690-8308
Mailing Address - Country:US
Mailing Address - Phone:231-421-5285
Mailing Address - Fax:231-421-5281
Practice Address - Street 1:3600 VETERANS DR STE 1
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4582
Practice Address - Country:US
Practice Address - Phone:231-421-5285
Practice Address - Fax:231-421-5281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based