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General NPI Number Information
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NPI Number | 1477007458
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Entity Type | Organization
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Legal Business Name | MAPLE CREEK HOSPICE INC
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 110 S MARKET ST
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City | SPARTA
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State | IL
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Zip | 62286-2062
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Country | US
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Telephone | 618-443-4671
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Fax |
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Provider Business Mailing Address
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Address Line | 301 SOVEREIGN CT
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City | BALLWIN
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State | MO
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Zip | 63011-4441
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Country | US
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Telephone | 314-631-3000
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KALYN NOEL GLODO
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Credential |
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Telephone | 618-443-4671
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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 |
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License Number State |
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