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General NPI Number Information
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NPI Number | 1659786259
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Entity Type | Organization
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Legal Business Name | ST CROIX HOSPICE LLC
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 802 LAKE ST STE 3
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City | SPIRIT LAKE
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State | IA
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Zip | 51360-1660
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Country | US
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Telephone | 712-264-5674
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Fax | 712-580-3043
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Provider Business Mailing Address
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Address Line | 7755 3RD ST N STE 200
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City | OAKDALE
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State | MN
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Zip | 55128-5442
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Country | US
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Telephone | 651-735-3656
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Fax | 651-735-0155
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Authorized Official
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Title or Position | CFO
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Name | STEPHEN PHENNEGER
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Credential |
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Telephone | 651-328-6934
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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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