Provider Demographics
NPI:1508015579
Name:ADVOCATE HOSPICE LLC
Entity Type:Organization
Organization Name:ADVOCATE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICALADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-529-2766
Mailing Address - Street 1:952 CHAMBERS ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-5107
Mailing Address - Country:US
Mailing Address - Phone:801-529-2766
Mailing Address - Fax:801-475-4346
Practice Address - Street 1:952 CHAMBERS ST STE 4
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-5107
Practice Address - Country:US
Practice Address - Phone:801-529-2766
Practice Address - Fax:801-475-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based