Provider Demographics
NPI:1871024794
Name:OLIVE GROVE HOSPICE LLC
Entity Type:Organization
Organization Name:OLIVE GROVE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-287-0265
Mailing Address - Street 1:12402 JAMESTOWN ST NE STE 200
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-7541
Mailing Address - Country:US
Mailing Address - Phone:651-287-0265
Mailing Address - Fax:651-287-0266
Practice Address - Street 1:12402 JAMESTOWN ST NE STE 200
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-7541
Practice Address - Country:US
Practice Address - Phone:651-287-0265
Practice Address - Fax:651-287-0266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based