Provider Demographics
NPI:1558078865
Name:MI HOSPICE HOLDINGS LLC
Entity type:Organization
Organization Name:MI HOSPICE HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOV
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-818-1700
Mailing Address - Street 1:1777 AVENUE OF THE STATES STE 106
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6205
Mailing Address - Country:US
Mailing Address - Phone:732-503-0364
Mailing Address - Fax:
Practice Address - Street 1:5206 STATE ROAD
Practice Address - Street 2:500
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1966
Practice Address - Country:US
Practice Address - Phone:866-865-7926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care