HOSPICE OF JACKSON - HOSPICE HOME (NPI# 1548523186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548523186 |
| Entity Type | Organization |
| Organization Name | HOSPICE OF JACKSON - HOSPICE HOME |
| Practice Address |
2150 Kingsbrooke Dr Jackson MI 49202-1300 |
| Practice Telephone | 5178177600 |
| Practice Fax Number | 5178177615 |
| Mailing Telephone | 5178177600 |
| Mailing Fax Number | 5178177615 |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2019-08-09 |
| Authorized Official Name | MRS. MARK SMITH (SVP - CMO, CEO - HFAMG) |
| Authorized Official Telephone | 5172056407 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | HOSPICE OF JACKSON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251G00000X | Hospice Care, Community Based | 1050000017 | MI | Agencies |
| Y | 315D00000X | Hospice, Inpatient | 1070000432 | MI | Nursing & Custodial Care Facilities |
| Street Address |
2150 KINGSBROOKE DR |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871889964 | Holistic Care Hospice of Jackson LLC | Hospice, Inpatient | 1757 University Blvd, 3, Jackson, MS 39204-3916 | 2011-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346878089 | Ecare LLC | Hospice, Inpatient | 5840 N Canton Center Rd Ste 267, Canton, MI 48187-2684 | 2020-03-30 |
| 1811461734 | Beaumont Ashn, LLC | Hospice, Inpatient | 1919 Technology Dr Ste B, Troy, MI 48083-4245 | 2019-01-14 |
| 1437589728 | Faith Hospice | Hospice, Inpatient | 8214 Pfeiffer Farms Dr Sw, Byron Center, MI 49315-8288 | 2013-11-22 |
| 1003818220 | Angela Hospice Home Care, Inc. | Hospice, Inpatient | 14100 Newburgh Rd, Livonia, MI 48154-5010 | 2005-06-01 |
| 1447800396 | Hilary Lopez | Hospice, Inpatient | 1210 W Saginaw St, Lansing, MI 48915-1927 | 2019-09-12 |
| 1851865786 | Beaumont Ashn, LLC | Hospice, Inpatient | 1410 E 14 Mile Rd, Madison Heights, MI 48071-1541 | 2019-01-14 |
| 1194890814 | Op Hospice, Inc | Hospice, Inpatient | 24293 Telegraph Rd, Suite 102, Southfield, MI 48034-3011 | 2006-11-21 |
| 1902981889 | Marlette Regional Hospital | Hospice, Inpatient | 2770 Main St, Marlette, MI 48453-1141 | 2006-10-26 |
| 1619089539 | Edward W. Sparrow Hospital Association | Hospice, Inpatient | 1210 W. Saginaw Street, Lansing, MI 48915-1999 | 2006-08-31 |
| 1427081694 | Henry Ford Health System | Hospice, Inpatient | 33464 Schoenherr Rd, Ste 140, Sterling Heights, MI 48312-6314 | 2006-07-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.