Provider Demographics
NPI:1699501882
Name:SPECIALIZED HOSPICE
Entity type:Organization
Organization Name:SPECIALIZED HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:816-795-7990
Mailing Address - Street 1:2311 S REDWOOD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2405
Mailing Address - Country:US
Mailing Address - Phone:816-795-7990
Mailing Address - Fax:816-400-1985
Practice Address - Street 1:1861 N ROCK RD STE 320
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1264
Practice Address - Country:US
Practice Address - Phone:316-766-0076
Practice Address - Fax:316-368-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based