MEDICARE: RESIDENTIAL HOSPICE OF MISSOURI, 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1568317741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDENTIAL HOSPICE OF MISSOURI, LLC

Provider Business Mailing Address
First Line	:	5440 CORPORATE DR STE 400
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48098-2645
Country	:	US
Telephone Number	:	866-902-5854
Fax Number	:	866-903-4000

Provider Business Practice Location Address
First Line	:	7611 STATE LINE RD STE 326
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-6801
Country	:	US
Telephone Number	:	866-902-2621
Fax Number	:	866-730-1385

Authorized Official
Title or Position	:	SENIOR VP OF ADMINISTRATION
Name	:	LEEANN LANG
Credential	:
Telephone Number	:	866-902-2621

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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