Provider Demographics
NPI:1568086056
Name:JOHN PAUL HOME HOSPICE LLC
Entity Type:Organization
Organization Name:JOHN PAUL HOME HOSPICE LLC
Other - Org Name:JOHN PAUL HOME HOSPICE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-440-3453
Mailing Address - Street 1:30800 TELEGRAPH RD STE 3700
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4583
Mailing Address - Country:US
Mailing Address - Phone:248-731-7457
Mailing Address - Fax:
Practice Address - Street 1:30800 TELEGRAPH RD STE 3700
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4583
Practice Address - Country:US
Practice Address - Phone:248-731-7457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based