Organization Name: | HOSPICE ADVANTAGE, LLC. |
NPI Number: | 1255393864 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAYANNE MYNSBERGE (COO) |
Mailing Address: | 3217 W M 76 Suite B West Branch |
State: | MI US |
Postal Code: | 486619179 |
Phone Number: | 9893432470 |
Fax Number: | 9893432471 |
NPI Enumeration Date: | 04/06/2006 |
NPI Last Update Date: | 01/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 823522 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |