1487844981 NPI number — ARBOR HOSPICE, INC.

Table of content: (NPI 1487844981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487844981 NPI number — ARBOR HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARBOR HOSPICE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PERSONALIZED NURSING SERVICE, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487844981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2366 OAK VALLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48103-8944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-794-5113
Provider Business Mailing Address Fax Number:
734-662-9000

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2366 OAK VALLEY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48103-8944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-794-5113
Provider Business Practice Location Address Fax Number:
734-662-9000
Provider Enumeration Date:
07/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROOKS
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
734-794-5113

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0E166 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 100125 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 123952 . This is a "GREAT LAKE HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 000000005460 . This is a "CAPE HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 009529 . This is a "MIDWEST HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: HS810003 . This is a "MCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P08713 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1610265 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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