Provider Demographics
NPI:1922803113
Name:UNIVERSAL PALLIATIVE CARE SERVICES PLLC
Entity type:Organization
Organization Name:UNIVERSAL PALLIATIVE CARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JORAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOGAKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-761-1035
Mailing Address - Street 1:24315 NORTHWESTERN HWY
Mailing Address - Street 2:ST 102B
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6815
Mailing Address - Country:US
Mailing Address - Phone:248-761-1035
Mailing Address - Fax:
Practice Address - Street 1:24315 NORTHWESTERN HWY STE 226
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6815
Practice Address - Country:US
Practice Address - Phone:248-761-1035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty