Provider Demographics
NPI:1831539766
Name:DIGNITY HOSPIC
Entity type:Organization
Organization Name:DIGNITY HOSPIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LITTLETOM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:810-969-5115
Mailing Address - Street 1:16182 MEREDITH CT
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-9095
Mailing Address - Country:US
Mailing Address - Phone:810-969-5115
Mailing Address - Fax:
Practice Address - Street 1:16182 MEREDITH CT
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-9095
Practice Address - Country:US
Practice Address - Phone:810-969-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherEIN