Provider Demographics
NPI:1831170190
Name:HOSPICE OF LANSING, INC.
Entity type:Organization
Organization Name:HOSPICE OF LANSING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-882-4500
Mailing Address - Street 1:3411 STONELEIGH DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-4821
Mailing Address - Country:US
Mailing Address - Phone:517-882-4500
Mailing Address - Fax:517-882-3010
Practice Address - Street 1:3411 STONELEIGH DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-4821
Practice Address - Country:US
Practice Address - Phone:517-882-4500
Practice Address - Fax:517-882-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-12
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI333511251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1831220Medicaid
MI231522Medicare ID - Type UnspecifiedHOSPICE PROVIDER #