Provider Demographics
NPI:1831395243
Name:RESIDENTIAL HOME HEALTH AND HOSPICE, INC.
Entity type:Organization
Organization Name:RESIDENTIAL HOME HEALTH AND HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWITTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-283-8839
Mailing Address - Street 1:5440 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2645
Mailing Address - Country:US
Mailing Address - Phone:866-902-4000
Mailing Address - Fax:866-903-4000
Practice Address - Street 1:1681 WOODBRIDGE PARK AVE.
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3197
Practice Address - Country:US
Practice Address - Phone:810-245-3300
Practice Address - Fax:810-245-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI443512251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI231603Medicare ID - Type Unspecified