Provider Demographics
NPI:1477307940
Name:CONSTELLATION HOSPICE OH LLC
Entity Type:Organization
Organization Name:CONSTELLATION HOSPICE OH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:STEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-551-4312
Mailing Address - Street 1:14 WESTPORT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3915
Mailing Address - Country:US
Mailing Address - Phone:203-663-6731
Mailing Address - Fax:203-845-8005
Practice Address - Street 1:1929 GREGORY LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1434
Practice Address - Country:US
Practice Address - Phone:315-504-4987
Practice Address - Fax:888-453-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based