Provider Demographics
NPI:1669957247
Name:SOUTHEASTERN HOSPICE SERVICES, LLC
Entity type:Organization
Organization Name:SOUTHEASTERN HOSPICE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOSPICE DEVELOPMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ABURTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-826-0900
Mailing Address - Street 1:1501 GRUNDY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-1506
Mailing Address - Country:US
Mailing Address - Phone:215-826-0900
Mailing Address - Fax:
Practice Address - Street 1:1501 GRUNDY LN STE 100
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-1506
Practice Address - Country:US
Practice Address - Phone:215-826-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based