Basic Information
| Provider Information | |||||||||
| NPI: | 1669711032 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPICE ADVANTAGE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 CENTER AVE | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487085939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898912210 | ||||||||
| FaxNumber: | 9898935268 | ||||||||
| Practice Location | |||||||||
| Address1: | 2258 SCHUETZ RD | ||||||||
| Address2: | SUITE 116 & 118 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631463423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3147314700 | ||||||||
| FaxNumber: | 9898935268 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2013 | ||||||||
| LastUpdateDate: | 03/17/2015 | ||||||||
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| AuthorizedOfficialLastName: | HILDEBRANT | ||||||||
| AuthorizedOfficialFirstName: | RODNEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9898912210 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 198-HO | MO | Y | Agencies | Hospice Care, Community Based |
No ID Information.