Provider Demographics
NPI:1689631954
Name:FOCUS CARE HOSPICE, INC
Entity Type:Organization
Organization Name:FOCUS CARE HOSPICE, INC
Other - Org Name:PASSAGES HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-4610
Mailing Address - Street 1:134 N MCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-5169
Mailing Address - Country:US
Mailing Address - Phone:847-695-1431
Mailing Address - Fax:847-329-9215
Practice Address - Street 1:21411 CIVIC CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3910
Practice Address - Country:US
Practice Address - Phone:248-569-4610
Practice Address - Fax:248-569-4764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251G0000X251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI154748575Medicaid
MI154748575Medicaid