Provider Demographics
NPI:1982069324
Name:MERIDIAN PALLIATIVE & HOSPICE CARE SERVICES LLC
Entity Type:Organization
Organization Name:MERIDIAN PALLIATIVE & HOSPICE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/TREASURER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTENEGRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-402-3306
Mailing Address - Street 1:4 N DEER POINT RD
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:HAINESVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3814
Mailing Address - Country:US
Mailing Address - Phone:847-543-7550
Mailing Address - Fax:
Practice Address - Street 1:4 N DEER POINT RD
Practice Address - Street 2:SUITE 1006
Practice Address - City:HAINESVILLE
Practice Address - State:IL
Practice Address - Zip Code:60030-3814
Practice Address - Country:US
Practice Address - Phone:847-543-7550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based