Provider Demographics
NPI:1164429262
Name:LOVEJOY HOSPICE, INC.
Entity Type:Organization
Organization Name:LOVEJOY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-474-1193
Mailing Address - Street 1:939 SE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-3109
Mailing Address - Country:US
Mailing Address - Phone:541-474-1193
Mailing Address - Fax:541-474-3034
Practice Address - Street 1:939 SE 8TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3109
Practice Address - Country:US
Practice Address - Phone:541-474-1193
Practice Address - Fax:541-474-3034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1989-005251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR131925Medicaid
OR1989-005OtherOR HOSPICE ASSN LICENSE #
38-1522Medicare ID - Type Unspecified