Provider Demographics
NPI:1558907824
Name:COMMUNITY HOSPICE, INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:KORRECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-689-6675
Mailing Address - Street 1:181 WEST RIVER VALLEY
Mailing Address - Street 2:
Mailing Address - City:NEWAYGO
Mailing Address - State:MI
Mailing Address - Zip Code:49337
Mailing Address - Country:US
Mailing Address - Phone:231-689-6675
Mailing Address - Fax:231-689-5038
Practice Address - Street 1:181 WEST RIVER VALLEY
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337
Practice Address - Country:US
Practice Address - Phone:231-689-6675
Practice Address - Fax:231-689-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based