Provider Demographics
NPI:1346018561
Name:JOURNEY HOSPICE LLC
Entity Type:Organization
Organization Name:JOURNEY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:N
Authorized Official - Last Name:CISSELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-517-3705
Mailing Address - Street 1:1314 W SAINT JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1563
Mailing Address - Country:US
Mailing Address - Phone:573-605-1202
Mailing Address - Fax:573-605-1203
Practice Address - Street 1:1314 W SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1563
Practice Address - Country:US
Practice Address - Phone:573-605-1202
Practice Address - Fax:573-605-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based