Healthcare Provider Details

I. General information

NPI: 1104759992
Provider Name (Legal Business Name): LILY HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 S COMMERCIAL ST
NEENAH WI
54956-4664
US

IV. Provider business mailing address

15430 W CAPITOL DR STE 100
BROOKFIELD WI
53005-2626
US

V. Phone/Fax

Practice location:
  • Phone: 262-235-3115
  • Fax:
Mailing address:
  • Phone: 262-235-3115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TRACY M GEIGER
Title or Position: PRESIDENT
Credential:
Phone: 262-525-1405