Provider Demographics
NPI:1598409450
Name:HULLSHAVEN
Entity Type:Organization
Organization Name:HULLSHAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-218-3609
Mailing Address - Street 1:401 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:KS
Mailing Address - Zip Code:67133-9578
Mailing Address - Country:US
Mailing Address - Phone:316-218-3609
Mailing Address - Fax:
Practice Address - Street 1:401 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:KS
Practice Address - Zip Code:67133-9578
Practice Address - Country:US
Practice Address - Phone:316-218-3609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based