Provider Demographics
NPI:1497159222
Name:365 HOSPICE, LLC
Entity Type:Organization
Organization Name:365 HOSPICE, LLC
Other - Org Name:HORIZONS HOSPICE, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REZK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-419-4901
Mailing Address - Street 1:411 ROSTRAVER RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1924
Mailing Address - Country:US
Mailing Address - Phone:724-243-2627
Mailing Address - Fax:
Practice Address - Street 1:411 ROSTRAVER RD
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1924
Practice Address - Country:US
Practice Address - Phone:724-243-2627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based