Healthcare Provider Details

I. General information

NPI: 1285862607
Provider Name (Legal Business Name): GRACE HOSPICE HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MARKHILL DR
SEVIERVILLE TN
37862-4023
US

IV. Provider business mailing address

700 MARKHILL DR
SEVIERVILLE TN
37862-4023
US

V. Phone/Fax

Practice location:
  • Phone: 865-428-2445
  • Fax: 865-774-0193
Mailing address:
  • Phone: 865-428-2445
  • Fax: 865-774-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: MRS. PEGGY LILLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 865-243-9077