Provider Demographics
NPI:1881953032
Name:HOSPICE ADVANTAGE, LLC.
Entity type:Organization
Organization Name:HOSPICE ADVANTAGE, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDEBRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-891-2210
Mailing Address - Street 1:401 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5939
Mailing Address - Country:US
Mailing Address - Phone:989-891-2210
Mailing Address - Fax:989-893-5268
Practice Address - Street 1:545 MAINSTREAM DR
Practice Address - Street 2:SUITE 413
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1201
Practice Address - Country:US
Practice Address - Phone:615-733-3600
Practice Address - Fax:615-733-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000618251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN441598Medicare Oscar/Certification