Provider Demographics
NPI:1639317605
Name:HOSPICE ANGELIC CARE
Entity Type:Organization
Organization Name:HOSPICE ANGELIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:989-525-1900
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48764-0033
Mailing Address - Country:US
Mailing Address - Phone:989-525-1900
Mailing Address - Fax:989-362-8429
Practice Address - Street 1:910 N TAWAS LAKE RD
Practice Address - Street 2:
Practice Address - City:EAST TAWAS
Practice Address - State:MI
Practice Address - Zip Code:48730-9772
Practice Address - Country:US
Practice Address - Phone:989-525-1900
Practice Address - Fax:989-362-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704208260251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based