Provider Demographics
NPI:1255668547
Name:5 STAR HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:5 STAR HOSPICE CARE, INC.
Other - Org Name:SAINT JUDE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-221-9155
Mailing Address - Street 1:13375 UNIVERSITY AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8260
Mailing Address - Country:US
Mailing Address - Phone:515-221-9155
Mailing Address - Fax:515-221-9157
Practice Address - Street 1:675 S. ARROYO PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3264
Practice Address - Country:US
Practice Address - Phone:626-229-9855
Practice Address - Fax:626-229-9856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001417251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551620Medicare Oscar/Certification