Provider Demographics
NPI:1992331128
Name:CARELINE HEALTH GROUP - MI LLC
Entity type:Organization
Organization Name:CARELINE HEALTH GROUP - MI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-212-9000
Mailing Address - Street 1:113 W MICHIGAN AVE STE 1024TH
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1340
Mailing Address - Country:US
Mailing Address - Phone:517-212-9000
Mailing Address - Fax:
Practice Address - Street 1:113 W MICHIGAN AVE STE 1024TH
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1340
Practice Address - Country:US
Practice Address - Phone:517-212-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based