Organization
CUSTOM HOSPICE, LLC
Active
Other names
Custom Palliative Care
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN FOSSEE (CEO)
(248) 629-2880
Entity
Organization
Contact information
Practice address
888 W BIG BEAVER RD STE 900, TROY, MI 48084-4771
(866) 952-9003
(866) 952-9004
Mailing address
888 W BIG BEAVER RD STE 900, TROY, MI 48084-4771
(866) 952-9003
(866) 952-9004
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/31/2019
Last updated
03/18/2021
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