Provider Demographics
NPI:1952547614
Name:DUE SEASON HOSPICE AND HOMECARE AGENCY, INC
Entity Type:Organization
Organization Name:DUE SEASON HOSPICE AND HOMECARE AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-734-0949
Mailing Address - Street 1:3806 CHAMBERLAYNE AVE STE 18A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4110
Mailing Address - Country:US
Mailing Address - Phone:804-400-6479
Mailing Address - Fax:
Practice Address - Street 1:3806 CHAMBERLAYNE AVE STE 18A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4110
Practice Address - Country:US
Practice Address - Phone:804-400-6479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization