Provider Demographics
NPI:1306086756
Name:SPRING VALLEY HOSPICE, LLC
Entity type:Organization
Organization Name:SPRING VALLEY HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:KENSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-558-4122
Mailing Address - Street 1:2200 S BOWMAN RD STE A
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4136
Mailing Address - Country:US
Mailing Address - Phone:501-558-4100
Mailing Address - Fax:501-558-4140
Practice Address - Street 1:7139 COMMERCE DR STE B3
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-2101
Practice Address - Country:US
Practice Address - Phone:662-890-5554
Practice Address - Fax:662-890-5746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS178251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based