Provider Demographics
NPI:1497479703
Name:WENATCHEE HOSPICE LLC
Entity Type:Organization
Organization Name:WENATCHEE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-710-7323
Mailing Address - Street 1:285 TECHNOLOGY CENTER WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-8120
Mailing Address - Country:US
Mailing Address - Phone:509-663-9585
Mailing Address - Fax:
Practice Address - Street 1:285 TECHNOLOGY CENTER WAY STE 108
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-8120
Practice Address - Country:US
Practice Address - Phone:509-663-9585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based