Organization Name: | HOSPICE OF JACKSON - HOSPICE HOME |
NPI Number: | 1548523186 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAWN MARIE SHARP (NURSING HOME ADMINISTRATOR) |
Mailing Address: | 2150 Kingsbrooke Dr Jackson |
State: | MI US |
Postal Code: | 492021300 |
Phone Number: | 5178177600 |
Fax Number: | 5178177615 |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 06/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 1050000017 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |