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General NPI Number Information
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NPI Number | 1134415433
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Entity Type | Organization
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Legal Business Name | HOSPICE ADVANTAGE, LLC.
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 6880 COBBLESTONE BLVD STE 2
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City | SOUTHAVEN
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State | MS
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Zip | 38672-9313
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Country | US
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Telephone | 662-393-4033
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Fax | 662-393-4031
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Provider Business Mailing Address
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Address Line | 10 CADILLAC DRIVE SUITE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-1001
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Country | US
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Telephone | 615-377-7022
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Fax | 615-373-4457
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Authorized Official
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Title or Position | SVP GENERAL COUNSEL
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Name | RUSSELL ADKINS
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Credential |
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Telephone | 615-926-0340
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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 | 183
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License Number State | MS
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