Provider Demographics
NPI:1982906939
Name:HOSPICE WITH HOPE, INC.
Entity Type:Organization
Organization Name:HOSPICE WITH HOPE, INC.
Other - Org Name:SAINT JUDE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:MORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-221-9155
Mailing Address - Street 1:13375 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8261
Mailing Address - Country:US
Mailing Address - Phone:515-221-9155
Mailing Address - Fax:515-221-9157
Practice Address - Street 1:919 FERNCLIFF CV
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2435
Practice Address - Country:US
Practice Address - Phone:662-393-4033
Practice Address - Fax:662-393-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS183251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS251656Medicare Oscar/Certification