Provider Demographics
NPI:1144381492
Name:ALTERNATIVE HOSPICE LLC
Entity Type:Organization
Organization Name:ALTERNATIVE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-349-2311
Mailing Address - Street 1:1749 GILSINN LN
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2003
Mailing Address - Country:US
Mailing Address - Phone:636-349-2311
Mailing Address - Fax:636-349-6491
Practice Address - Street 1:1749 GILSINN LN
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2003
Practice Address - Country:US
Practice Address - Phone:636-349-2311
Practice Address - Fax:636-349-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO828894808Medicaid
MO828894808Medicaid