Provider Demographics
NPI:1174867584
Name:SAINT JOSEPH HOSPICE, LLC
Entity Type:Organization
Organization Name:SAINT JOSEPH HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:T
Authorized Official - Last Name:QUIRIT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:630-225-7271
Mailing Address - Street 1:490 LAKE STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3500
Mailing Address - Country:US
Mailing Address - Phone:630-225-7271
Mailing Address - Fax:630-225-7279
Practice Address - Street 1:490 LAKE STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-3500
Practice Address - Country:US
Practice Address - Phone:630-225-7271
Practice Address - Fax:630-225-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based