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General NPI Number Information
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NPI Number | 1275527970
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Entity Type | Organization
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Legal Business Name | TRADITIONS HOSPICE OF GLEN ALLEN, LLC
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 10128 W BROAD ST STE A
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6761
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Country | US
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Telephone | 804-290-0951
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Fax |
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Provider Business Mailing Address
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Address Line | 6840 CAROTHERS PKWY STE 550
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City | FRANKLIN
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State | TN
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Zip | 37067-8002
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Country | US
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Telephone | 979-704-6547
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Fax | 866-908-8704
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | BRIAN LANTIER
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Credential |
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Telephone | 979-704-6547
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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 | 0511715
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License Number State | VA
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