Healthcare Provider Details

I. General information

NPI: 1548584394
Provider Name (Legal Business Name): GROVES COMMUNITY HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 WOODS CHAPEL RD STE A
KANSAS CITY MO
64139-1355
US

IV. Provider business mailing address

7434 SKOKIE BLVD
SKOKIE IL
60077-3341
US

V. Phone/Fax

Practice location:
  • Phone: 816-836-1096
  • Fax:
Mailing address:
  • Phone: 847-982-2300
  • Fax: 847-982-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number10763
License Number StateMO

VIII. Authorized Official

Name: DAVID ZUCKERMAN
Title or Position: COMPTROLLER
Credential:
Phone: 847-982-2300