Provider Demographics
NPI:1710372537
Name:REVERENCE HOME HEALTH AND HOSPICE
Entity Type:Organization
Organization Name:REVERENCE HOME HEALTH AND HOSPICE
Other - Org Name:ASCENSION AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-658-2768
Mailing Address - Street 1:PO BOX 674402
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-4402
Mailing Address - Country:US
Mailing Address - Phone:810-606-5090
Mailing Address - Fax:810-606-5522
Practice Address - Street 1:1000 HEALTH PARK BLVD
Practice Address - Street 2:STE A
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7324
Practice Address - Country:US
Practice Address - Phone:810-606-5090
Practice Address - Fax:810-606-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies