Provider Demographics
NPI:1114506409
Name:SUPPORTIVE CARE PLUS
Entity Type:Organization
Organization Name:SUPPORTIVE CARE PLUS
Other - Org Name:HOSPICE CARE PLUS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-986-1500
Mailing Address - Street 1:208 KIDD DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-9593
Mailing Address - Country:US
Mailing Address - Phone:859-986-1500
Mailing Address - Fax:
Practice Address - Street 1:208 KIDD DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-9593
Practice Address - Country:US
Practice Address - Phone:859-986-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPICE CARE PLUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-05
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based