Provider Demographics
NPI:1477977700
Name:ALTERNATIVE HOSPICE LLC
Entity Type:Organization
Organization Name:ALTERNATIVE HOSPICE LLC
Other - Org Name:ALTERNATIVE PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-349-2311
Mailing Address - Street 1:1749 GILSINN LN
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2008
Mailing Address - Country:US
Mailing Address - Phone:636-343-3839
Mailing Address - Fax:636-343-6367
Practice Address - Street 1:1749 GILSINN LN
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2008
Practice Address - Country:US
Practice Address - Phone:636-343-3839
Practice Address - Fax:636-343-6367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE HOSPICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO20010163522084H0002X
MO142859363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084H0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyHospice and Palliative MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty