MEDICARE: MORSELIFE HOSPICE INSTITUTE, INC.

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

General Provider Information

NPI Number	:	1306130281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORSELIFE HOSPICE INSTITUTE, INC.

Provider Business Mailing Address
First Line	:	4847 DAVID S MACK DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417-8023
Country	:	US
Telephone Number	:	561-209-6108
Fax Number	:	651-689-8718

Provider Business Practice Location Address
First Line	:	4855 FRED GLADSTONE DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33417
Country	:	US
Telephone Number	:	561-736-0294
Fax Number	:	561-369-3544

Authorized Official
Title or Position	:	CONTROLLER
Name	:	RANDY WOLAN
Credential	:
Telephone Number	:	561-209-6108

Provider Enumeration Date	:	06/08/2011
Last Update Date	:	02/20/2019

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