Provider Demographics
NPI:1154162857
Name:ABODE HOSPICE OF FLORIDA, LLC
Entity type:Organization
Organization Name:ABODE HOSPICE OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-828-2210
Mailing Address - Street 1:4200 NW 90TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-3809
Mailing Address - Country:US
Mailing Address - Phone:352-378-2121
Mailing Address - Fax:
Practice Address - Street 1:4200 NW 90TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-3809
Practice Address - Country:US
Practice Address - Phone:352-378-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient