Organization
LIFE CARE AT HOME OF MICHIGAN INC
Active
Other names
AFFINITY HOSPICE OF LIFE
Organization subpart
No
Provider details
NPI number
Authorized official
PAM RAU (VICE PRESIDENT FINANCE)
(423) 473-5280
Entity
Organization
Contact information
Practice address
15450 NORTHLINE RD, SUITE 102, SOUTHGATE, MI 48195-2398
(734) 284-4315
(734) 284-6125
Mailing address
3001 KEITH ST NW, CLEVELAND, TN 37312-3713
(423) 473-5280
(423) 339-8356
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08734
BLUE CROSS BLUE SHIELD MICHIGAN
MI
05
—
155177372
—
MI
Enumeration date
05/19/2006
Last updated
01/24/2013
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