Provider Demographics
NPI:1962731042
Name:HEALTH1ST HOSPICE LLC
Entity type:Organization
Organization Name:HEALTH1ST HOSPICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:RITA
Authorized Official - Last Name:ADENIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, CNAA, BC
Authorized Official - Phone:610-513-7587
Mailing Address - Street 1:1230 BURMONT RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4504
Mailing Address - Country:US
Mailing Address - Phone:610-513-7587
Mailing Address - Fax:610-449-1187
Practice Address - Street 1:1230 BURMONT RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4504
Practice Address - Country:US
Practice Address - Phone:610-513-7587
Practice Address - Fax:610-449-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X, 251J00000X, 253Z00000X
PAAPPLIED251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care