Provider Demographics
NPI:1124253943
Name:HOSPICE SERVICES OF AMERICA LLC
Entity type:Organization
Organization Name:HOSPICE SERVICES OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:G
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-796-3421
Mailing Address - Street 1:PO BOX 22925
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-0925
Mailing Address - Country:US
Mailing Address - Phone:330-533-4001
Mailing Address - Fax:
Practice Address - Street 1:584 E MAIN ST
Practice Address - Street 2:SUITE 40
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1589
Practice Address - Country:US
Practice Address - Phone:330-533-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHV66.7251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based