Provider Demographics
NPI:1184627499
Name:REGIONAL HOSPICE SERVICES,INC.
Entity type:Organization
Organization Name:REGIONAL HOSPICE SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:715-685-5151
Mailing Address - Street 1:1913 BEASER AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-3604
Mailing Address - Country:US
Mailing Address - Phone:715-685-5151
Mailing Address - Fax:715-682-6404
Practice Address - Street 1:1913 BEASER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-3604
Practice Address - Country:US
Practice Address - Phone:715-685-5151
Practice Address - Fax:715-682-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI526251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43183200Medicaid
WI43183200Medicaid