Provider Demographics
NPI:1790739282
Name:FAITH HOSPICE
Entity Type:Organization
Organization Name:FAITH HOSPICE
Other - Org Name:HOSPICE OF HOLLAND HOME AND FAITH HOSPICE AT TRILLIUM WOODS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-235-5015
Mailing Address - Street 1:2100 RAYBROOK ST SE
Mailing Address - Street 2:STE 303
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5783
Mailing Address - Country:US
Mailing Address - Phone:616-235-5100
Mailing Address - Fax:616-235-5050
Practice Address - Street 1:2100 RAYBROOK ST SE
Practice Address - Street 2:STE 303
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5783
Practice Address - Country:US
Practice Address - Phone:616-235-5100
Practice Address - Fax:616-235-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
08762OtherBCBS OF MICHIGAN
MI3161730Medicaid
231570Medicare Oscar/Certification