# RESIDENTIAL HOSPICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Residential Palliative Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528773132
- **Authorized official:** JUSTIN DEWITTE (CEO)
- **Authorized official phone:** (866) 902-4000

## Contact information

- **Practice address:** 1745 INDIAN WOOD CIR STE 252, MAUMEE, OH 43537-4168
- **Practice address phone:** (567) 218-2075
- **Practice address fax:** (855) 618-6655
- **Mailing address:** 5440 CORPORATE DR STE 400, TROY, MI 48098-2645
- **Mailing address phone:** (866) 902-4000
- **Mailing address fax:** (866) 903-4000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2023
- **Last updated:** 11/09/2023