Provider Demographics
NPI:1497356091
Name:COMMONWEALTH HOSPICE
Entity Type:Organization
Organization Name:COMMONWEALTH HOSPICE
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 1:30600 NORTHWESTERN HWY STE 245
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3171
Mailing Address - Country:US
Mailing Address - Phone:248-957-1999
Mailing Address - Fax:888-990-0589
Practice Address - Street 1:821 DANIEL SHAYS HWY
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-6903
Practice Address - Country:US
Practice Address - Phone:516-857-5077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based