HEART TO HEART HOSPICE OF SOUTHGATE LLC NPI 1073936787

NPI Information

NPI: 1073936787
Provider Name: HEART TO HEART HOSPICE OF SOUTHGATE, LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 23D2012399

Address:
1 HERITAGE DR STE 107
SOUTHGATE, MI
ZIP 48195
Phone: (734) 282-0209
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HEART TO HEART HOSPICE OF SOUTHGATE, LLC is a hospice care community based in Southgate, MI. HEART TO HEART HOSPICE OF SOUTHGATE, LLC NPI is 1073936787. The provider is registered as an organization entity type.

The provider's business location address is:

1 HERITAGE DR STE 107
SOUTHGATE, MI
ZIP 48195-736
Phone: (734) 282-0209
Fax: (734) 282-0266

The provider's authorized official is Kelly O Mitchell .
The authorized official title is Manager and has the following contact phone number (972) 517-6300.

The CLIA number assigned to this NPI record is 23D2012399 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2014 and was last updated on 10/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	231620	MEDICARE OSCAR/CERTIFICATION	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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