Provider Demographics
NPI:1891977955
Name:NORTHWEST HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:NORTHWEST HOSPICE CARE, INC.
Other - Org Name:HEART & SOUL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-942-1779
Mailing Address - Street 1:1900 N. MACARTHUR BLVD.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-2650
Mailing Address - Country:US
Mailing Address - Phone:405-942-1779
Mailing Address - Fax:
Practice Address - Street 1:1900 N. MACARTHUR BLVD.
Practice Address - Street 2:SUITE 103
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2650
Practice Address - Country:US
Practice Address - Phone:405-942-1779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based