Basic Information
| Provider Information | |||||||||
| NPI: | 1548584394 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GROVES COMMUNITY HOSPICE, LLC | ||||||||
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| OtherOrganizationName: | ONE COMMUNITY HOSPICE & PALLIATIVE CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7434 SKOKIE BLVD | ||||||||
| Address2: | |||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600773341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479822300 | ||||||||
| FaxNumber: | 8479822304 | ||||||||
| Practice Location | |||||||||
| Address1: | 15600 WOODS CHAPEL RD STE A | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641391355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8168361096 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2010 | ||||||||
| LastUpdateDate: | 10/11/2019 | ||||||||
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| AuthorizedOfficialLastName: | ZUCKERMAN | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | COMPTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 8479822300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 363LA2200X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LF0000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 251G00000X | 10763 | MO | Y | Agencies | Hospice Care, Community Based |
No ID Information.