MEDICARE: ADAPTIVE HOSPICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1093260697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAPTIVE HOSPICE, LLC

Provider Business Mailing Address
First Line	:	2916 PEACH BLOSSOM DR STE 106
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-8380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2916 PEACH BLOSSOM DR STE 106
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-8380
Country	:	US
Telephone Number	:	812-590-1575
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HEATH A BARTNESS
Credential	:
Telephone Number	:	651-328-6914

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	11/02/2022

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