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Organization

HOSPICE OF LENAWEE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TRAVIS J HAVENS BS, CDP (PRESIDENT & CEO)
(517) 263-2323
Entity
Organization

Contact information

Practice address
1903 WOLF CREEK HWY, ADRIAN, MI 49221-8460
(517) 263-2323
(517) 263-1425
Mailing address
1903 WOLF CREEK HWY, ADRIAN, MI 49221-8460
(517) 263-2323
(517) 263-1425

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
463510
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08771
BLUE CROSS BLUE SHIELD
MI
05
2720163
MI
01
463510
STATE OF MICHIGAN LICENSE
MI
Enumeration date
03/08/2007
Last updated
08/12/2019
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