Provider Demographics
NPI:1447256003
Name:ARBOR HOSPICE, INC.
Entity type:Organization
Organization Name:ARBOR HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEE ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-578-6244
Mailing Address - Street 1:2366 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8944
Mailing Address - Country:US
Mailing Address - Phone:888-992-2273
Mailing Address - Fax:
Practice Address - Street 1:2366 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8944
Practice Address - Country:US
Practice Address - Phone:734-662-5999
Practice Address - Fax:734-662-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X
MI814140313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI08713OtherBLUE CROSS HOSPICE
MI123952OtherGREAT LAKES HEALTH PLAN
MI009529OtherMIDWEST HEALTH PLAN
MIP08713OtherBLUE CARE NETWORK
MI000000005460OtherCAPE HEALTH PLAN
MI100125OtherCARE CHOICES
MI1931397Medicaid
MI4076348Medicaid
MIHS810003OtherMCARE
MI009529OtherMIDWEST HEALTH PLAN