Provider Demographics
NPI:1487844981
Name:ARBOR HOSPICE, INC.
Entity Type:Organization
Organization Name:ARBOR HOSPICE, INC.
Other - Org Name:PERSONALIZED NURSING SERVICE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, CHCE
Authorized Official - Phone:734-794-5113
Mailing Address - Street 1:2366 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8944
Mailing Address - Country:US
Mailing Address - Phone:734-794-5113
Mailing Address - Fax:734-662-9000
Practice Address - Street 1:2366 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8944
Practice Address - Country:US
Practice Address - Phone:734-794-5113
Practice Address - Fax:734-662-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E166OtherBLUE CROSS BLUE SHIELD
MI100125OtherCARE CHOICES
MI123952OtherGREAT LAKE HEALTH PLAN
MI000000005460OtherCAPE HEALTH PLAN
MI009529OtherMIDWEST HEALTH PLAN
MIHS810003OtherMCARE
MIP08713OtherBLUE CARE NETWORK
MI1610265Medicaid
MI237157Medicare PIN