NPI 1104928332 · live from the CMS NPI Registry
Hospice Advantage, LLC
Hospice Care, Community Based in Union Grove, WI. National Provider Identifier 1104928332, active.
NPI record
| NPI | 1104928332 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospice Care, Community Based 251G00000X |
| Practice location | 951 Main St, Suite 120, Union Grove, WI 53182 |
| Practice phone | 262-864-4145 |
| Mailing address | 401 Center Ave, Bay City, MI 48708 |
| Enumerated | September 1, 2006 |
| Last updated | January 15, 2013 |
| Authorized official | Kayanne Mynsberge, Coo |
| Other names | Hospice Advantage, INC |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based primary | 251G00000X | 2017 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.