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General NPI Number Information
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NPI Number | 1003836560
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Entity Type | Organization
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Legal Business Name | HOSPICE OF THE ROCK RIVER VALLEY
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 2706 AVENUE E
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City | STERLING
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State | IL
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Zip | 61081-4602
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Country | US
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Telephone | 815-625-3858
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Fax | 815-625-6152
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Provider Business Mailing Address
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Address Line | 2706 AVENUE E
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City | STERLING
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State | IL
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Zip | 61081-4602
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Country | US
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Telephone | 815-625-3858
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Fax | 815-625-6152
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JACQUELINE ANN DONALDSON
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Credential | RN
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Telephone | 815-625-3858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 2000164
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License Number State | IL
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