Active NPI
Mi Hospice Holdings LLC
Doing business as Swan Hospice
- Inpatient Hospice
- Flint, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Inpatient Hospice
- Legal business name
- MI HOSPICE HOLDINGS LLC
- Doing business as
- Swan Hospice
- Practice address
- 5206 State Road
500
Flint, MI 48507-1966 - Phone
- (866) 865-7926
- NPI assigned
- Nov 7, 2022
- Last updated
- Mar 17, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dov Green
- Title
- Ceo
- Phone
- (908) 818-1700
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | |||
| Inpatient Hospice | 315D00000X | Primary | ||
| Respite Care | 385H00000X |
Addresses
Primary practice location
5206 State Road
500
Flint, MI 48507-1966
Mailing address
1777 Avenue of the States Ste 106
Lakewood, NJ 08701-6205
Phone (732) 503-0364
Other names 1
- Swan Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230301002395 | MI | Part A Provider - Hospice | 3779956362 | Practice locations: Flint, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1558078865. Details of each certification follow.
Hospice certification: CCN 231682
- Legal name
- MI HOSPICE HOLDINGS LLC
- Doing business as
- SWAN HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 21, 2020
- Last certification
- Aug 21, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jul 13, 2022 in DE
- Enrollment address
- 5206 Gateway Ctr
Ste C
Flint, MI 48507-3920
Care Compare: Hospice
Medicare Care Compare- Listed as
- Swan Hospice
- Ownership
- For-Profit
- Certified
- Aug 21, 2020
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
5206 Gateway Ctr
Ste C
Flint, MI 48507
Phone (586) 307-4552
1777 Avenue of the States
Ste 106
Lakewood, NJ 08701
Phone (908) 818-1700
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Dov Green | 5% Or Greater Direct Ownership Interest | Nov 1, 2022 | 22.34% |
| Corporate Officer | Nov 1, 2022 | ||
| Yoni Klein | 5% Or Greater Direct Ownership Interest | Nov 1, 2022 | 22.33% |
| W-2 Managing Employee | Nov 1, 2022 | ||
| Chana Miriam Wilhelm | 5% Or Greater Direct Ownership Interest | Nov 1, 2022 | 33% |
| Corporate Officer | Nov 1, 2022 | ||
| Boruch D Mermelstein | 5% Or Greater Direct Ownership Interest | Nov 1, 2022 | 22.33% |
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Nov 1, 2022 | Change of Ownership | United Hospice Care LLC |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Community Based Hospice Care Agency
- Flint, MI
- NPI 1679034417
Acquired from, 2022-11-01
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667779200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742169600000",
"number": "1558078865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 AVENUE OF THE STATES STE 106",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087016205",
"telephone_number": "732-503-0364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5206 STATE ROAD",
"address_2": "500",
"city": "FLINT",
"state": "MI",
"postal_code": "485071966",
"telephone_number": "866-865-7926"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MI HOSPICE HOLDINGS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-07",
"last_updated": "2025-03-17",
"certification_date": "2025-03-12",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "DOV",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "908-818-1700"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "315D00000X",
"taxonomy_group": "",
"desc": "Hospice, Inpatient",
"state": null,
"license": null,
"primary": true
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Swan Hospice",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Swan Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.