Healthcare Provider Details

I. General information

NPI: 1457659252
Provider Name (Legal Business Name): GENERATIONS HOSPICE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 LONGVIEW RD STE 101
MISSOURI VALLEY IA
51555-1200
US

IV. Provider business mailing address

1010 LONGVIEW ROAD SUITE 101
MISSOURI VALLEY IA
51555
US

V. Phone/Fax

Practice location:
  • Phone: 712-642-2264
  • Fax: 712-642-2578
Mailing address:
  • Phone: 712-642-2264
  • Fax: 712-642-2578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KELLY JOHN SHERER
Title or Position: HOSPICE ADMINISTRATOR
Credential: M.S.
Phone: 402-881-2844