Provider Demographics
NPI:1831645076
Name:HRS HOSPICE, INC
Entity Type:Organization
Organization Name:HRS HOSPICE, INC
Other - Org Name:HRS COMPREHENSIVE PRIVATE DUTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-604-3742
Mailing Address - Street 1:1806 S. HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4933
Mailing Address - Country:US
Mailing Address - Phone:312-604-3742
Mailing Address - Fax:
Practice Address - Street 1:1806 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4933
Practice Address - Country:US
Practice Address - Phone:312-604-3742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4000428251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4000428OtherSTATE LICENSE NUMBER