Provider Demographics
NPI:1639338908
Name:SEASONS HOSPICE & PALLIATIVE CARE OF DELAWARE, LLC
Entity Type:Organization
Organization Name:SEASONS HOSPICE & PALLIATIVE CARE OF DELAWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEGAL
Authorized Official - Prefix:
Authorized Official - First Name:REENE
Authorized Official - Middle Name:
Authorized Official - Last Name:A COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-201-3779
Mailing Address - Street 1:6400 SHAFER CT
Mailing Address - Street 2:STE 700
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4914
Mailing Address - Country:US
Mailing Address - Phone:847-759-9449
Mailing Address - Fax:
Practice Address - Street 1:300 BIDDLE AVE
Practice Address - Street 2:STE 205
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3969
Practice Address - Country:US
Practice Address - Phone:866-443-9856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEHSPC010Medicaid
DEHSPC010Medicaid