Provider Demographics
NPI:1114241437
Name:ALIVE HOSPICE, INC.
Entity Type:Organization
Organization Name:ALIVE HOSPICE, INC.
Other - Org Name:ALIVE PALLIATIVE CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOESSELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-327-1085
Mailing Address - Street 1:1718 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2926
Mailing Address - Country:US
Mailing Address - Phone:615-327-1085
Mailing Address - Fax:615-320-1948
Practice Address - Street 1:1718 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2926
Practice Address - Country:US
Practice Address - Phone:615-327-1085
Practice Address - Fax:615-320-1948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519726OtherMEDICARE PART B
TN1519726Medicaid
TN1519726OtherMEDICARE PART B