Provider Demographics
NPI:1285862607
Name:GRACE HOSPICE HOUSE LLC
Entity Type:Organization
Organization Name:GRACE HOSPICE HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-243-9077
Mailing Address - Street 1:700 MARKHILL DR
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-4023
Mailing Address - Country:US
Mailing Address - Phone:865-428-2445
Mailing Address - Fax:865-774-0193
Practice Address - Street 1:700 MARKHILL DR
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-4023
Practice Address - Country:US
Practice Address - Phone:865-428-2445
Practice Address - Fax:865-774-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient