Provider Demographics
NPI:1952647398
Name:SISTERS HOSPICE & PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:SISTERS HOSPICE & PALLIATIVE CARE LLC
Other - Org Name:BAPTIST HOSPICE GROUP LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETTYE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAPTIST-WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-355-2721
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-0006
Mailing Address - Country:US
Mailing Address - Phone:901-355-2721
Mailing Address - Fax:
Practice Address - Street 1:1305 CHURCH RD E
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9711
Practice Address - Country:US
Practice Address - Phone:901-355-2721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based