Provider Demographics
NPI:1700123668
Name:HOSPICE CARE OF MICHIGAN
Entity Type:Organization
Organization Name:HOSPICE CARE OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YOGI
Authorized Official - Middle Name:
Authorized Official - Last Name:PANCHOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-425-5500
Mailing Address - Street 1:15608 FARMINGTON RD
Mailing Address - Street 2:STE # C
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2852
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15608 FARMINGTON RD
Practice Address - Street 2:STE # C
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-2852
Practice Address - Country:US
Practice Address - Phone:734-425-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based