Healthcare Provider Details

I. General information

NPI: 1750494514
Provider Name (Legal Business Name): HOSPICE ADVANTAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 12/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N STATE ROUTE 7
PLEASANT HILL MO
64080-1426
US

IV. Provider business mailing address

10 CADILLAC DR SUITE 400
BRENTWOOD TN
37027-5078
US

V. Phone/Fax

Practice location:
  • Phone: 816-228-2500
  • Fax: 816-795-7818
Mailing address:
  • Phone: 615-377-7022
  • Fax: 615-373-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHO-161
License Number StateMO

VIII. Authorized Official

Name: ANTHONY JAMES
Title or Position: CFO
Credential:
Phone: 615-425-5418