Healthcare Provider Details

I. General information

NPI: 1164411450
Provider Name (Legal Business Name): HOPE HOSPICE AND PALLIATIVE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 W BROADWAY AVE
MEDFORD WI
54451-1610
US

IV. Provider business mailing address

537 W BROADWAY AVE
MEDFORD WI
54451-1610
US

V. Phone/Fax

Practice location:
  • Phone: 715-748-3434
  • Fax: 715-748-1268
Mailing address:
  • Phone: 715-748-3434
  • Fax: 715-748-1268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number43180200
License Number StateWI

VIII. Authorized Official

Name: NICOLE SYRYCZUK
Title or Position: DIRECTOR
Credential:
Phone: 715-748-3434