Healthcare Provider Details

I. General information

NPI: 1104001163
Provider Name (Legal Business Name): TRI-COUNTY HOSPICE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1614 W. BUSINESS HWY 60 STE. A-2
DEXTER MO
63841
US

IV. Provider business mailing address

3010 LYNDON B JOHNSON FWY STE 1100
DALLAS TX
75234-2712
US

V. Phone/Fax

Practice location:
  • Phone: 573-614-4000
  • Fax: 903-537-8420
Mailing address:
  • Phone: 517-768-4373
  • Fax: 903-537-8420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATIE LYNN MONASTIERE
Title or Position: COMPLIANCE PRIVACY & SAFETY OFFICER
Credential:
Phone: 517-768-4373