Provider Demographics
NPI:1679779367
Name:HOPE HOSPICE, INC.
Entity type:Organization
Organization Name:HOPE HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAULIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-224-4673
Mailing Address - Street 1:PO BOX 621
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975-0621
Mailing Address - Country:US
Mailing Address - Phone:574-224-4673
Mailing Address - Fax:574-224-4444
Practice Address - Street 1:2316 E STATE RD 14
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46975
Practice Address - Country:US
Practice Address - Phone:574-224-4673
Practice Address - Fax:574-224-4444
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-21
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
IN11-005301-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
157104Medicare Oscar/Certification