Heart to Heart Hospice of Detroit LLC
Organization Active NPI Community Based Hospice Care Agency · Bingham Farms, MI
NPI 1831485697 · NPPES record last updated May 14, 2018
Key facts
- NPI
- 1831485697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- HEART TO HEART HOSPICE OF DETROIT LLC
- Practice address
- 30600 Telegraph Rd Ste 1131
Bingham Farms, MI 48025 - Phone
- (248) 952-9000
- Fax
- (248) 952-9004
- NPI assigned
- Jun 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Mr. Kelly O Mitchell
- Title
- Ceo
- Phone
- (972) 517-6300
Owners & managing parties with NPI records 1
-
Steven Katzman, D.O.
Facilities with the same owner 40
Practitioners 1
-
Steven Katzman, D.O.
Affiliated clinicians 23
-
Ali Alsaadi, M.D.
-
Rebecca R Baumbach, M.D.
-
Mirella F. Ducu, M.D.
-
Kenneth B Gallmore II, D.O.
-
Faris Hannoodi, M.D.
-
Michael J Haroutunian, D.O.
-
Wayel T Katrib, M.D
-
Jeffrey A Kraft, DO
-
Zachary Thomas Lemon, D.O.
-
Shyam Mahesh, M.D.
-
Ronak R Patel, DO
-
Lisa Gilbert Peleman, M.D.
-
William M Rudy, D.O.
Medicare Care Compare: Hospice
- Listed as
- Heart to Heart Hospice of Detroit, LLC
- Ownership
- For-Profit
- Certified
- Mar 28, 2013
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2029803 | Heart to Heart Hospice of Detroit, LLC | Certificate of waiver | Sep 14, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Hospice certification: CCN 231625
- Legal name
- HEART TO HEART HOSPICE OF DETROIT LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 28, 2013
- Last certification
- Mar 28, 2013
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC · Proprietary
- Enrollment address
- 30600 Telegraph Rd
Ste 1131
Bingham Farms, MI 48025-4531
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Heart to Heart Hospice Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 18, 2013 | 100% |
| HTHH Atlas, LLC |
5% Or Greater Indirect Ownership Interest | Oct 27, 2021 | 0.25% |
| H to H Founders, LLC |
5% Or Greater Indirect Ownership Interest | Jun 25, 2015 | 59.83% |
| Htohh Preferred LLC |
5% Or Greater Indirect Ownership Interest | Oct 27, 2021 | 39.92% |
| Steven M Katzman |
Corporate Director |
Jan 18, 2024 | |
| Michigan Medical Couriers and Express Delivery Services, LLC |
5% Or Greater Direct Ownership Interest | Oct 27, 2021 | 100% |
| Nicole Lewis |
W-2 Managing Employee |
Apr 11, 2022 | |
| Kelly Mitchell |
5% Or Greater Indirect Ownership Interest |
Jun 1, 2016 | 65.87% |
| Corporate Officer | Jul 18, 2013 | ||
| W-2 Managing Employee |
Jul 18, 2013 | ||
| Theresa Loftice |
Corporate Officer |
Jan 18, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110809000750 | MI | Part a Provider - Hospice | 3971772815 | Practice locations: Bingham Farms, MI; Troy, MI |
| O20210210000768 | MI | Part B Supplier - Clinic/Group Practice | 3971772815 |
Receives reassigned benefits from 1 practitioner Practice locations: Bingham Farms, MI |
National Provider Directory
Locations
30800 Telegraph Rd
Ste 1850
Bingham Farms, MI 48025
Phone (248) 952-9000
5990 N Adams Rd
Fl 1
Troy, MI 48098
Phone (248) 602-5793
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
30600 Telegraph Rd Ste 1131
Bingham Farms, MI 48025
Mailing address
7240 Chase Oaks Blvd
Plano, TX 75025-5901
Phone (972) 517-6300
Other providers in Bingham Farms, MI
- Lauren R Hawk
- Lara Rie Hayden
- Diamond B Haynes
- Kaitlyn Nicole Head
- Shaterian Heard
- Alexis Heckert
- JP Christian Heinemann
- Sunshrae Heller
- Andrew Helton
- Kim Nicole Henderson
All providers in Bingham Farms, MI · Community Based Hospice Care Agency in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.