Provider Demographics
NPI:1710296405
Name:ALLAY HOME AND HOSPICE, INC.
Entity Type:Organization
Organization Name:ALLAY HOME AND HOSPICE, INC.
Other - Org Name:GENERATIONS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-810-1079
Mailing Address - Street 1:1028 S MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-6109
Mailing Address - Country:US
Mailing Address - Phone:920-922-0134
Mailing Address - Fax:920-933-3710
Practice Address - Street 1:1028 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-6109
Practice Address - Country:US
Practice Address - Phone:920-922-0134
Practice Address - Fax:920-933-3710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI521590OtherMEDICARE PTAN HOSPICE
527312OtherMEDICARE PTAN