MEDICARE: NEW HAVEN HOSPICE CARE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1558806356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HAVEN HOSPICE CARE INC

Provider Business Mailing Address
First Line	:	9503 HIGHWAY 100
Second Line	:	SUITE 101
City	:	NEW HAVEN
State	:	MO
Zip	:	63068-1300
Country	:	US
Telephone Number	:	573-237-2878
Fax Number	:

Provider Business Practice Location Address
First Line	:	9503 HIGHWAY 100
Second Line	:	SUITE 101
City	:	NEW HAVEN
State	:	MO
Zip	:	63068-1300
Country	:	US
Telephone Number	:	573-237-2878
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DOROTHY SHARPE
Credential	:	RN
Telephone Number	:	573-237-2878

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	01/03/2017

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