Provider Demographics
NPI:1215235494
Name:SEASONS HOSPICE & PALLIATIVE CARE OF MISSOURI, LLC
Entity type:Organization
Organization Name:SEASONS HOSPICE & PALLIATIVE CARE OF MISSOURI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP LEGAL
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SISCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-909-6200
Mailing Address - Street 1:6400 SHAFER CT
Mailing Address - Street 2:STE 700
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4914
Mailing Address - Country:US
Mailing Address - Phone:847-692-1148
Mailing Address - Fax:
Practice Address - Street 1:3660 S GEYER RD
Practice Address - Street 2:STE 120
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1223
Practice Address - Country:US
Practice Address - Phone:314-909-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO261641Medicare Oscar/Certification