Provider Demographics
NPI:1013561711
Name:SIGNAL HEALTH GROUP, HOSPICE CARE INC.
Entity Type:Organization
Organization Name:SIGNAL HEALTH GROUP, HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIEM
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHERBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-408-4564
Mailing Address - Street 1:333 N ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 N ALABAMA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2034
Practice Address - Country:US
Practice Address - Phone:800-260-6145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based