Provider Demographics
NPI:1417130170
Name:ADENA HOSPICE, LLC
Entity Type:Organization
Organization Name:ADENA HOSPICE, LLC
Other - Org Name:ADENA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-779-7582
Mailing Address - Street 1:2077 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-7506
Mailing Address - Country:US
Mailing Address - Phone:740-779-4663
Mailing Address - Fax:740-779-4674
Practice Address - Street 1:2077 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-7506
Practice Address - Country:US
Practice Address - Phone:740-779-4663
Practice Address - Fax:740-779-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062805Medicaid
OH361591Medicare Oscar/Certification