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General NPI Number Information
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NPI Number | 1801136643
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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 | 02/14/2013
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 2960 ALLIED ST STE 105
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City | GREEN BAY
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State | WI
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Zip | 54304-5542
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Country | US
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Telephone | 920-321-2004
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Fax | 920-321-2005
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Provider Business Mailing Address
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Address Line | 10 CADILLAC DR STE 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 | 615-309-5668
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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 | 2036
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License Number State | WI
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