Provider Demographics
NPI:1417494212
Name:ENTERA HOSPICE, INC.
Entity Type:Organization
Organization Name:ENTERA HOSPICE, INC.
Other - Org Name:AVAYA HOSPICE INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ARROJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-324-5550
Mailing Address - Street 1:10700 W HIGGINS ROAD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-3729
Mailing Address - Country:US
Mailing Address - Phone:847-324-5550
Mailing Address - Fax:847-324-5552
Practice Address - Street 1:10700 W HIGGINS ROAD
Practice Address - Street 2:SUITE 340
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-3729
Practice Address - Country:US
Practice Address - Phone:847-324-5550
Practice Address - Fax:877-992-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based