Provider Demographics
NPI:1740548577
Name:EMMANUEL HOSPICE
Entity type:Organization
Organization Name:EMMANUEL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:TORREY
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-737-6267
Mailing Address - Street 1:401 HALL ST SW STE 263
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4988
Mailing Address - Country:US
Mailing Address - Phone:166-719-0919
Mailing Address - Fax:616-719-0933
Practice Address - Street 1:401 HALL ST SW STE 263
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4988
Practice Address - Country:US
Practice Address - Phone:166-719-0919
Practice Address - Fax:616-719-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based