Provider Demographics
NPI:1861503534
Name:AGRACE HOSPICECARE, INCORPORATED
Entity Type:Organization
Organization Name:AGRACE HOSPICECARE, INCORPORATED
Other - Org Name:HOSPICECARE INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-276-4660
Mailing Address - Street 1:5395 E CHERYL PKWY
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5395
Mailing Address - Country:US
Mailing Address - Phone:608-276-4660
Mailing Address - Fax:608-327-7268
Practice Address - Street 1:5395 E CHERYL PKWY
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5395
Practice Address - Country:US
Practice Address - Phone:608-276-4660
Practice Address - Fax:608-327-7268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43180100Medicaid
WI43180100Medicaid
WI521505Medicare Oscar/Certification
WI521505Medicare PIN