Provider Demographics
NPI:1477169811
Name:ADVANCE CARE HOSPICE, LLC
Entity Type:Organization
Organization Name:ADVANCE CARE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:STROUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-897-9056
Mailing Address - Street 1:585 SOUTHLAKE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3198
Mailing Address - Country:US
Mailing Address - Phone:804-897-9056
Mailing Address - Fax:
Practice Address - Street 1:585 SOUTHLAKE BLVD STE A
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3198
Practice Address - Country:US
Practice Address - Phone:804-897-9056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based