Provider Demographics
NPI:1922870096
Name:OPTIMAL HOSPICE OF MICHIGAN INC
Entity Type:Organization
Organization Name:OPTIMAL HOSPICE OF MICHIGAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GENENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-237-6440
Mailing Address - Street 1:33250 WARREN RD STE 15
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2920
Mailing Address - Country:US
Mailing Address - Phone:734-237-6440
Mailing Address - Fax:734-237-6445
Practice Address - Street 1:33250 WARREN RD STE 15
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2920
Practice Address - Country:US
Practice Address - Phone:734-237-6440
Practice Address - Fax:734-237-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1040000104OtherLICENSING AND REGULATORY AFFAIRS