Provider Demographics
NPI:1578225363
Name:DEVOTIONAL AND LOVING CARE HOSPICE LLC
Entity Type:Organization
Organization Name:DEVOTIONAL AND LOVING CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CEPHASE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ETUGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-242-3656
Mailing Address - Street 1:1000 W WILSHIRE BLVD STE 403C
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 W WILSHIRE BLVD STE 403C
Practice Address - Street 2:
Practice Address - City:NICHOLS HILLS
Practice Address - State:OK
Practice Address - Zip Code:73116-7055
Practice Address - Country:US
Practice Address - Phone:405-242-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based