Provider Demographics
NPI:1558750067
Name:ASHBY HOSPICE LLC
Entity Type:Organization
Organization Name:ASHBY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:JANETTE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-478-2521
Mailing Address - Street 1:11576 S STATE ST STE 1202B
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7119
Mailing Address - Country:US
Mailing Address - Phone:801-478-2521
Mailing Address - Fax:801-797-8667
Practice Address - Street 1:11576 S STATE ST STE 1202B
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7119
Practice Address - Country:US
Practice Address - Phone:801-478-2521
Practice Address - Fax:801-797-8667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9116925-0160251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based