Provider Demographics
NPI:1518073840
Name:PALLIATIVE CARE CONSULTANTS NFP
Entity Type:Organization
Organization Name:PALLIATIVE CARE CONSULTANTS NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WISDOM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:888-233-1708
Mailing Address - Street 1:305 S ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-2133
Mailing Address - Country:US
Mailing Address - Phone:800-233-1708
Mailing Address - Fax:618-235-3130
Practice Address - Street 1:211 S 3RD ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1915
Practice Address - Country:US
Practice Address - Phone:800-233-1708
Practice Address - Fax:618-235-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management