NPIMap

Organization Active NPI

Hospice of Jackson

  • Community Based Hospice Care Agency
  • Jackson, MI
National Provider Identifier
1992892301
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
383510 Issued in MI
Legal business name
HOSPICE OF JACKSON
Practice address
205 N East Ave
One Jackson Square, Suite 400
Jackson, MI 49201-1753
Phone
(517) 841-6982
Fax
(517) 841-6987
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robin Damschroder
Title
Cfo
Phone
(313) 876-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 383510 MI Primary

Addresses

Primary practice location

205 N East Ave
One Jackson Square, Suite 400
Jackson, MI 49201-1753

Mailing address

205 N East Ave
One Jackson Square, Suite 400
Jackson, MI 49201-1753
Phone (517) 841-6982

Other identifiers 7

IdentifierTypeStateIssuer
1825474-16MedicaidMI
500458OtherMICARE CHOICE
08712OtherMIBLUE CROSS OF MICHIGAN
70031199OtherMIACS
HS380001OtherMIMCARE
0078OtherMIHEALTH PLAN OF MICHIGAN
50-20015OtherMIPHYSICIAN'S HEALTH PLAN

Other names 1

  • Henry Ford Allegiance Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080926000227 MI Part A Provider - Hospice 1557435153 Practice locations: Jackson, MI

Hospice certification: CCN 231523

Legal name
HOSPICE OF JACKSON
Doing business as
HENRY FORD ALLEGIANCE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 17, 1987
Last certification
May 12, 2017
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Enrollment address
100 E Michigan Ave
Ste 400
Jackson, MI 49201-1498

Care Compare: Hospice

Medicare Care Compare
Listed as
Henry Ford Health Hospice-Central MichiganCCN 231523
Ownership
For-Profit
Certified
Jun 17, 1987
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0939890Henry Ford Allegiance Home Care & Hospice100 E Michigan Avenue Suite 400, Jackson, MI 49201Certificate of waiverFeb 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Hospice of Jackson2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

205 N East Ave
Ste 400
Jackson, MI 49201
Phone (517) 841-6982

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael a. Grisdela Individual W-2 Managing EmployeeAssociate Cfo Feb 1, 2025
Henry Ford Health System Organization, Detroit, MI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2016 100%
Jon M Lake Individual Corporate DirectorBoard Member Jan 1, 2022
Jeremy Michael Curtis Individual W-2 Managing EmployeeManager Feb 9, 2026
Emily Moorhead Individual Corporate DirectorPresident Jan 1, 2020
Healthlink Organization, Jackson, MI Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 11, 2007 100%
Robin S. Damschroder Individual Corporate OfficerPresident, Val Based ENT &Cfo Jan 1, 2022
Chelsea Page Individual Corporate OfficerVP Marketing Feb 9, 2026
Sandra Place Individual Corporate DirectorBoard Member Jan 1, 2021
Colleen Elizabeth Howing Individual W-2 Managing EmployeeMD; Feb 9, 2026
Henry Ford Allegiance Health Group Organization, Jackson, MI Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 11, 2007 100%
Angela Eagling Individual Corporate OfficerNursing Home Adminstrator Feb 9, 2026
W-2 Managing EmployeeAd; Feb 9, 2026
Christina Marie Siders Individual Corporate OfficerChair Person May 24, 2017
Al Kauffman Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 25

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 25

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1992892301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "address_2": "ONE JACKSON SQUARE, SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-841-6982",
            "fax_number": "517-841-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "address_2": "ONE JACKSON SQUARE, SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-841-6982",
            "fax_number": "517-841-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF JACKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "DAMSCHRODER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "313-876-8452"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MI",
            "license": "383510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1825474-16",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICE",
            "identifier": "500458",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MICHIGAN",
            "identifier": "08712",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "70031199",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "HS380001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN",
            "identifier": "0078",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S HEALTH PLAN",
            "identifier": "50-20015",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry Ford Allegiance Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.