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General NPI Number Information
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NPI Number | 1508015579
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Entity Type | Organization
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Legal Business Name | ADVOCATE HOSPICE LLC
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Dates
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Enumeration Date | 09/15/2008
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 952 CHAMBERS ST STE 4
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-5107
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Country | US
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Telephone | 801-529-2766
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Fax | 801-475-6029
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Provider Business Mailing Address
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Address Line | 952 CHAMBERS ST STE 4
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City | SOUTH OGDEN
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State | UT
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Zip | 84403-5107
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Country | US
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Telephone | 801-529-2766
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Fax | 801-475-4346
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Authorized Official
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Title or Position | OWNER/CLINICALADMINISTRATOR
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Name | ANNETTE M WOOD
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Credential | R.N.
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Telephone | 801-529-2766
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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 | 251G00000X
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License Number State | UT
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