GRACE HOSPICE OF WISCONSIN, LLC (NPI# 1336487347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336487347 |
| Entity Type | Organization |
| Organization Name | GRACE HOSPICE OF WISCONSIN, LLC |
| Other Organization Name | GRACE HOSPICE |
| Practice Address |
2514 S 102nd St Ste 276 West Allis WI 53227-2142 |
| Mailing Address |
Po Box 99278 Troy MI 48099-9278 |
| Practice Telephone | 4143958650 |
| Practice Fax Number | 8558451846 |
| Mailing Telephone | 2488246000 |
| Mailing Fax Number | 8556186655 |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | RAJIV N PATEL (CEO/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 2488246609 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1336487347 | 05 | |
| WI | STATE HOSPICE LICENSE | 2039 | 01 |
| Other Name | Type Code |
|---|---|
| Grace Hospice | Doing Business As Name - Organization |
| Street Address |
2514 S 102ND ST STE 276 |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-2142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750359220 | Methodist Manor of Waukesha, Inc. | Hospice Care, Community Based | 8300 W Beloit Rd, West Allis, WI 53219-2412 | 2006-03-10 |
| 1538160163 | Odyssey Healthcare Operating B Lp | Hospice Care, Community Based | 10150 W National Ave, Suite 200, West Allis, WI 53227-2145 | 2005-08-04 |
| 1407853112 | Seasons Hospice & Palliative Care of Wisconsin, Inc | Hospice Care, Community Based | 6737 W Washington St, Suite 2150, West Allis, WI 53214-5647 | 2005-07-07 |
| 1134382930 | Visiting Nurse Association of Wisconsin Inc | Hospice Care, Community Based | 11333 W National Ave, West Allis, WI 53227-3111 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992317762 | Castle Senior Living, Inc | Hospice Care, Community Based | 13050 W Cleveland Ave, New Berlin, WI 53151-4013 | 2020-08-21 |
| 1982215307 | Moments Hospice of Appleton LLC | Hospice Care, Community Based | 806 Valley Rd Ste 1, Menasha, WI 54952-1120 | 2020-08-10 |
| 1992316319 | Moments Hospice of Madison LLC | Hospice Care, Community Based | 5315 Wall St Ste 135, Madison, WI 53718-7963 | 2020-08-10 |
| 1912531997 | Moments Hospice of Milwaukee | Hospice Care, Community Based | 1139 S Sunnyslope Dr Ste 200, Mt Pleasant, WI 53406-3998 | 2020-02-27 |
| 1194375915 | Moments Hospice of Eau Claire LLC | Hospice Care, Community Based | 2263 East Ridge Center, Eau Claire, WI 54701 | 2019-09-13 |
| 1871052944 | Kenya Pratt | Hospice Care, Community Based | 5510 N 33rd St, Milwaukee, WI 53209-4834 | 2019-03-18 |
| 1518432749 | Brighton Hospice Wisconsin | Hospice Care, Community Based | 300 N Executive Dr Ste 110, Brookfield, WI 53005-6016 | 2018-10-03 |
| 1184136939 | Legacy Hospice Cares LLC | Hospice Care, Community Based | 850 Elm Grove Rd Ste 21, Elm Grove, WI 53122-2527 | 2017-11-02 |
| 1720523210 | Holistic Hospice Inc | Hospice Care, Community Based | 3422 W Howard Ave, Greenfield, WI 53221-1208 | 2016-12-20 |
| 1740722586 | Bani Inc | Hospice Care, Community Based | 7434 N Lannon Rd, Lannon, Lannon, WI 53046-9746 | 2016-11-10 |
| Find all providers with the same taxonomy | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
Please comment or provide details below to improve the information on GRACE HOSPICE OF WISCONSIN, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.